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General NPI Number Information
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NPI Number | 1750324406
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Entity Type | Organization
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Legal Business Name | PHILADELPHIA VAMC
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Dates
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Enumeration Date | 06/13/2006
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Last Update Date | 01/05/2023
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Provider Practice Location Address
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Address Line | 3000 LINCOLN DRIVE SUITE E
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City | MARLTON
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State | NJ
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Zip | 08053-1500
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Country | US
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Telephone | 717-277-6565
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 94446
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City | CLEVELAND
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State | OH
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Zip | 44101-4446
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Country | US
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Telephone | 717-277-6565
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Fax |
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Authorized Official
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Title or Position | NPI TEAM MEMBER
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Name | MS. 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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