MEDICARE: DENVER 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	261QV0200X	VA Clinic/Center

General Provider Information

NPI Number	:	1336878164
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DENVER VAMC

Provider Business Mailing Address
First Line	:	PO BOX 94455
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44101-4455
Country	:	US
Telephone Number	:	913-578-4409
Fax Number	:	913-578-4536

Provider Business Practice Location Address
First Line	:	1365 GARDEN OF THE GODS RD STE 105
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80907-3419
Country	:	US
Telephone Number	:	913-578-4409
Fax Number	:	913-578-4536

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

Provider Enumeration Date	:	06/07/2022
Last Update Date	:	08/10/2022

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