MEDICARE: CINCINNATI 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	332100000X	Department of Veterans Affairs (VA) Pharmacy

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	3636098	OTHER	OH	NCPDP#

General Provider Information

NPI Number	:	1114985116
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CINCINNATI VAMC

Provider Business Mailing Address
First Line	:	PO BOX 94476
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44101-4476
Country	:	US
Telephone Number	:	608-821-7200
Fax Number	:	608-821-7658

Provider Business Practice Location Address
First Line	:	3200 VINE ST
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45220-2213
Country	:	US
Telephone Number	:	513-861-3100
Fax Number	:	513-475-6974

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

Provider Enumeration Date	:	05/02/2006
Last Update Date	:	02/24/2023

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Directions to “CINCINNATI VAMC ” Practice Location

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