Healthcare Provider Details

I. General information

NPI: 1588617815
Provider Name (Legal Business Name): COLUMBIA VAMC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/18/2006
Last Update Date: 07/07/2025
Certification Date: 07/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1380 CELEBRATION BLVD
FLORENCE SC
29501-5495
US

IV. Provider business mailing address

PO BOX 89478
CLEVELAND OH
44101-6478
US

V. Phone/Fax

Practice location:
  • Phone: 828-257-2333
  • Fax: 828-257-2399
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 POTTER
Title or Position: NPI TEAM
Credential:
Phone: 202-382-2579