Healthcare Provider Details

I. General information

NPI: 1023708401
Provider Name (Legal Business Name): PITTSBURGH VAMC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/10/2023
Last Update Date: 05/10/2023
Certification Date: 05/10/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

421 MALL CIRCLE DR
MONROEVILLE PA
15146-2207
US

IV. Provider business mailing address

PO BOX 94447
CLEVELAND OH
44101-4447
US

V. Phone/Fax

Practice location:
  • Phone: 717-277-6568
  • Fax:
Mailing address:
  • Phone: 717-277-6568
  • 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: ERIN DENISE POTTER
Title or Position: NPI TEAM LEAD
Credential:
Phone: 202-382-2579