MEDICARE: HONOLULU 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
1	261QV0200X	VA Clinic/Center

General Provider Information

NPI Number	:	1053367458
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HONOLULU VAMC

Provider Business Mailing Address
First Line	:	PO BOX 94406
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44101-4406
Country	:	US
Telephone Number	:	702-341-3020
Fax Number	:

Provider Business Practice Location Address
First Line	:	73-5618 MAIAU ST STE C200
Second Line	:
City	:	KAILUA KONA
State	:	HI
Zip	:	96740-2635
Country	:	US
Telephone Number	:	702-341-3020
Fax Number	:

Authorized Official
Title or Position	:	NPI TEAM
Name	:	ERIN POTTER
Credential	:
Telephone Number	:	202-382-2579

Provider Enumeration Date	:	05/26/2006
Last Update Date	:	11/15/2024

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Directions to “HONOLULU VAMC ” Practice Location

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