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NPI Code Detail

MEDICARE: CLEVELAND VAMC

MEDICARE: CLEVELAND 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 : 1104865971
Entity Type Code : Organization
Provider Name (Legal Business Name) : CLEVELAND VAMC
Provider Business Mailing Address
First Line : PO BOX 94477
Second Line :
City : CLEVELAND
State : OH
Zip : 44101-4477
Country : US
Telephone Number : 608-821-7200
Fax Number : 608-821-7658
Provider Business Practice Location Address
First Line : 1460 TOD AVE NW
Second Line :
City : WARREN
State : OH
Zip : 44485-2407
Country : US
Telephone Number : 608-821-7200
Fax Number : 608-821-7658
Authorized Official
Title or Position : NPI TEAM
Name : ERIN POTTER
Credential :
Telephone Number : 202-382-2579
Provider Enumeration Date : 06/06/2006
Last Update Date : 02/24/2023

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Directions to “CLEVELAND VAMC ” Practice Location

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