Healthcare Provider Details

I. General information

NPI: 1598419632
Provider Name (Legal Business Name): BIRMINGHAM VAMC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/08/2022
Last Update Date: 03/29/2022
Certification Date: 03/29/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7901 CRESTWOOD BLVD
IRONDALE AL
35210-2611
US

IV. Provider business mailing address

PO BOX 89430
CLEVELAND OH
44101-6430
US

V. Phone/Fax

Practice location:
  • Phone: 828-257-2333
  • Fax:
Mailing address:
  • Phone: 828-257-2333
  • Fax: 828-257-2399

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QV0200X
TaxonomyVA Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ERIN DENISE POTTER
Title or Position: NPI TEAM MEMBER
Credential:
Phone: 202-382-2579