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General NPI Number Information
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NPI Number | 1801854328
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Entity Type | Organization
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Legal Business Name | PRESCOTT VAMC
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Dates
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Enumeration Date | 05/03/2006
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Last Update Date | 01/13/2023
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Provider Practice Location Address
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Address Line | 500 N HWY 89
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City | PRESCOTT
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State | AZ
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Zip | 86313-5001
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Country | US
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Telephone | 928-445-4860
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Fax | 928-776-5301
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Provider Business Mailing Address
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Address Line | PO BOX 94411
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City | CLEVELAND
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State | OH
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Zip | 44101-4411
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Country | US
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Telephone | 702-341-3152
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Fax |
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Authorized Official
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Title or Position | NPI TEAM
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Name | ERIN DENISE 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 | 332100000X
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Taxonomy Name | Department of Veterans Affairs (VA) Pharmacy
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License Number |
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License Number State |
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