Healthcare Provider Details

I. General information

NPI: 1053379974
Provider Name (Legal Business Name): DUBLIN VAMC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/02/2006
Last Update Date: 02/08/2022
Certification Date: 02/08/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1826 VETERANS BLVD-HWY 80
DUBLIN GA
31021-3620
US

IV. Provider business mailing address

PO BOX 89488
CLEVELAND OH
44101-6488
US

V. Phone/Fax

Practice location:
  • Phone: 478-272-1210
  • Fax: 478-277-2816
Mailing address:
  • Phone: 828-257-2333
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332100000X
TaxonomyDepartment of Veterans Affairs (VA) Pharmacy
License Number
License Number State

VIII. Authorized Official

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