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General NPI Number Information
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NPI Number | 1811220742
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Entity Type | Organization
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Legal Business Name | FARGO VAMC
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Dates
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Enumeration Date | 09/10/2009
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Last Update Date | 11/13/2025
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Provider Practice Location Address
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Address Line | 1407 24TH AVE S
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City | GRAND FORKS
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State | ND
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Zip | 58201-6761
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Country | US
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Telephone | 913-578-4409
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 94452
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City | CLEVELAND
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State | OH
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Zip | 44101-4452
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Country | US
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Telephone | 913-578-4409
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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 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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