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NPI Code Detail

MEDICARE: ALBUQUERQUE VAMC

MEDICARE: ALBUQUERQUE VAMC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QV0200XVA Clinic/Center

General Provider Information

NPI Number : 1053353102
Entity Type Code : Organization
Provider Name (Legal Business Name) : ALBUQUERQUE VAMC
Provider Business Mailing Address
First Line : PO BOX 89495
Second Line :
City : CLEVELAND
State : OH
Zip : 44101-6495
Country : US
Telephone Number : 702-341-3152
Fax Number :
Provider Business Practice Location Address
First Line : 624 UNIVERSITY AVE
Second Line :
City : LAS VEGAS
State : NM
Zip : 87701-4278
Country : US
Telephone Number : 702-341-3152
Fax Number :
Authorized Official
Title or Position : NPI TEAM MEMBER
Name : ERIN POTTER
Credential :
Telephone Number : 202-382-2579
Provider Enumeration Date : 06/12/2006
Last Update Date : 10/31/2017

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Directions to “ALBUQUERQUE VAMC ” Practice Location

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