=====================================================
General NPI Number Information
=====================================================
NPI Number | 1093600173
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | RICHMOND VAMC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/10/2025
-----------------------------------------------------
Last Update Date | 06/10/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3107 HUNGARY SPRING RD
-----------------------------------------------------
City | RICHMOND
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 23228-2421
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 828-257-2333
-----------------------------------------------------
Fax | 828-257-2399
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 89464
-----------------------------------------------------
City | CLEVELAND
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 44101-6464
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 828-257-2333
-----------------------------------------------------
Fax | 828-257-2399
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | NPI TEAM
-----------------------------------------------------
Name | ERIN DENISE POTTER
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 202-382-2579
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QV0200X
-----------------------------------------------------
Taxonomy Name | VA Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------