MEDICARE: BOSTON 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	2235100	OTHER	MA	NCPDP#

General Provider Information

NPI Number	:	1326006461
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BOSTON VAMC

Provider Business Mailing Address
First Line	:	PO BOX 94432
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44101-4432
Country	:	US
Telephone Number	:	717-277-6565
Fax Number	:

Provider Business Practice Location Address
First Line	:	150 SOUTH HUNTINGTON AVE
Second Line	:
City	:	BOSTON
State	:	MA
Zip	:	02130-4893
Country	:	US
Telephone Number	:	857-364-4418
Fax Number	:	857-364-2319

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

Provider Enumeration Date	:	05/01/2006
Last Update Date	:	01/11/2023

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Directions to “BOSTON VAMC ” Practice Location

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