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NPI 1003869843

NPI 1003869843 : SAGINAW VAMC : GAYLORD, MI

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General NPI Number Information
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    NPI Number           |    1003869843
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    Entity Type          |    Organization 
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    Legal Business Name  |    SAGINAW VAMC 
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Dates
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    Enumeration Date     |    05/19/2006
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    Last Update Date     |    10/12/2023
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Provider Practice Location Address
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    Address Line         |    2782 S OTSEGO AVE 
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    City                 |    GAYLORD
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    State                |    MI
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    Zip                  |    49735-9404
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    Country              |    US
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    Telephone            |    608-821-7200
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    Fax                  |    608-821-7658
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Provider Business Mailing Address
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    Address Line         |    PO BOX 94487 
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    City                 |    CLEVELAND
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    State                |    OH
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    Zip                  |    44101-4487
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    Country              |    US
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    Telephone            |    608-821-7200
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    Fax                  |    608-821-7658
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Authorized Official
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    Title or Position    |    NPI TEAM
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    Name                 |     ERIN  POTTER 
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    Credential           |    
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    Telephone            |    202-382-2579
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    261QV0200X
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    Taxonomy Name        |    VA Clinic/Center
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    License Number       |    
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    License Number State |    
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