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NPI Code Detail

MEDICARE: LOMA LINDA VAMC

MEDICARE: LOMA LINDA 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
1332100000XDepartment of Veterans Affairs (VA) Pharmacy

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
10569333OTHERCANCPDP#

General Provider Information

NPI Number : 1255399952
Entity Type Code : Organization
Provider Name (Legal Business Name) : LOMA LINDA VAMC
Provider Business Mailing Address
First Line : PO BOX 94409
Second Line :
City : CLEVELAND
State : OH
Zip : 44101-4409
Country : US
Telephone Number : 702-341-3152
Fax Number :
Provider Business Practice Location Address
First Line : 11201 BENTON ST
Second Line :
City : LOMA LINDA
State : CA
Zip : 92357-1000
Country : US
Telephone Number : 909-825-7084
Fax Number : 909-422-3017
Authorized Official
Title or Position : NPI TEAM MEMBER
Name : ERIN POTTER
Credential :
Telephone Number : 202-382-2579
Provider Enumeration Date : 05/02/2006
Last Update Date : 10/23/2018

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Directions to “LOMA LINDA VAMC ” Practice Location

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