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NPI Code Detail

MEDICARE: SALT LAKE CITY VAMC

MEDICARE: SALT LAKE CITY 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 : 1295126621
Entity Type Code : Organization
Provider Name (Legal Business Name) : SALT LAKE CITY VAMC
Provider Business Mailing Address
First Line : PO BOX 94463
Second Line :
City : CLEVELAND
State : OH
Zip : 44101-4463
Country : US
Telephone Number : 913-578-4409
Fax Number :
Provider Business Practice Location Address
First Line : 2767 MOUNTAIN CITY HWY
Second Line :
City : ELKO
State : NV
Zip : 89801-2414
Country : US
Telephone Number : 913-578-4409
Fax Number :
Authorized Official
Title or Position : NPI TEAM
Name : ERIN POTTER
Credential :
Telephone Number : 202-382-2579
Provider Enumeration Date : 02/06/2015
Last Update Date : 01/14/2026

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Directions to “SALT LAKE CITY VAMC ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.