Healthcare Provider Details

I. General information

NPI: 1497703409
Provider Name (Legal Business Name): MONTANA VAMC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/04/2006
Last Update Date: 10/19/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 VETERANS DRIVE
COLUMBIA FALLS MT
59912
US

IV. Provider business mailing address

PO BOX 94451
CLEVELAND OH
44101-4451
US

V. Phone/Fax

Practice location:
  • Phone: 406-758-2741
  • Fax: 406-892-5551
Mailing address:
  • Phone: 913-578-4409
  • 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 POTTER
Title or Position: NPI TEAM MEMBER
Credential:
Phone: 202-382-2579