Healthcare Provider Details

I. General information

NPI: 1669766564
Provider Name (Legal Business Name): NORTHAMPTON VAMC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/08/2011
Last Update Date: 01/10/2023
Certification Date: 11/22/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

403 BELMONT ST STE 1
WORCESTER MA
01604-1020
US

IV. Provider business mailing address

PO BOX 94444
CLEVELAND OH
44101-4444
US

V. Phone/Fax

Practice location:
  • Phone: 717-277-6565
  • Fax:
Mailing address:
  • Phone: 717-277-6565
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

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