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1679531800

NPI Code Detail

MEDICARE: SHERIDAN VAMC

MEDICARE: SHERIDAN VAMC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332100000X	Department of Veterans Affairs (VA) Pharmacy

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	5203702	OTHER	WY	NCPDP#

General Provider Information

NPI Number	:	1679531800
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SHERIDAN VAMC

Provider Business Mailing Address
First Line	:	PO BOX 94464
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44101-4464
Country	:	US
Telephone Number	:	913-578-4409
Fax Number	:

Provider Business Practice Location Address
First Line	:	1898 FORT RD
Second Line	:
City	:	SHERIDAN
State	:	WY
Zip	:	82801-8320
Country	:	US
Telephone Number	:	307-672-3473
Fax Number	:	307-675-3954

Authorized Official
Title or Position	:	NPI TEAM MEMBER
Name	:	ERIN DENISE POTTER
Credential	:
Telephone Number	:	202-382-2579

Provider Enumeration Date	:	05/04/2006
Last Update Date	:	07/09/2019

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Directions to “SHERIDAN VAMC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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