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NPI Code Detail

MEDICARE: HONOLULU VAMC

MEDICARE: HONOLULU 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 : 1396791356
Entity Type Code : Organization
Provider Name (Legal Business Name) : HONOLULU VAMC
Provider Business Mailing Address
First Line : PO BOX 94406
Second Line :
City : CLEVELAND
State : OH
Zip : 44101-4406
Country : US
Telephone Number : 702-341-3020
Fax Number :
Provider Business Practice Location Address
First Line : 45 MOHOULI ST
Second Line :
City : HILO
State : HI
Zip : 96720-7210
Country : US
Telephone Number : 702-341-3020
Fax Number :
Authorized Official
Title or Position : NPI TEAM MEMBER
Name : ERIN POTTER
Credential :
Telephone Number : 202-382-2579
Provider Enumeration Date : 05/25/2006
Last Update Date : 02/04/2020

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Directions to “HONOLULU VAMC ” Practice Location

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