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NPI Code Detail

MEDICARE: OMAHA VAMC

MEDICARE: OMAHA 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
12816924OTHERNENCPDP#

General Provider Information

NPI Number : 1356399372
Entity Type Code : Organization
Provider Name (Legal Business Name) : OMAHA VAMC
Provider Business Mailing Address
First Line : PO BOX 94460
Second Line :
City : CLEVELAND
State : OH
Zip : 44101-4460
Country : US
Telephone Number : 913-578-4409
Fax Number :
Provider Business Practice Location Address
First Line : 420 VICTORY PARK DR
Second Line :
City : LINCOLN
State : NE
Zip : 68510-2484
Country : US
Telephone Number : 402-489-3802
Fax Number : 612-725-1092
Authorized Official
Title or Position : NPI TEAM MEMBER
Name : ERIN DENISE POTTER
Credential :
Telephone Number : 202-382-2579
Provider Enumeration Date : 05/04/2006
Last Update Date : 03/07/2023

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Directions to “OMAHA VAMC ” Practice Location

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