MEDICARE: OKLAHOMA 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
1	332100000X	Department of Veterans Affairs (VA) Pharmacy

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	3729223	OTHER		NCPDP

General Provider Information

NPI Number	:	1386002178
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OKLAHOMA CITY VAMC

Provider Business Mailing Address
First Line	:	PO BOX 94537
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44101-4537
Country	:	US
Telephone Number	:	913-578-4409
Fax Number	:

Provider Business Practice Location Address
First Line	:	7919 MID AMERICA BLVD
Second Line	:	SUITE 300
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73135-6610
Country	:	US
Telephone Number	:	615-355-3451
Fax Number	:

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

Provider Enumeration Date	:	02/08/2016
Last Update Date	:	04/04/2018

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Directions to “OKLAHOMA CITY VAMC ” Practice Location

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