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NPI Code Detail

MEDICARE: CHEYENNE VAMC

MEDICARE: CHEYENNE 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 : 1528013083
Entity Type Code : Organization
Provider Name (Legal Business Name) : CHEYENNE VAMC
Provider Business Mailing Address
First Line : PO BOX 94454
Second Line :
City : CLEVELAND
State : OH
Zip : 44101-4454
Country : US
Telephone Number : 913-578-4409
Fax Number :
Provider Business Practice Location Address
First Line : 2509 RESEARCH BLVD
Second Line :
City : FORT COLLINS
State : CO
Zip : 80526-8108
Country : US
Telephone Number : 913-578-4409
Fax Number :
Authorized Official
Title or Position : NPI TEAM MEMBER
Name : ERIN POTTER
Credential :
Telephone Number : 202-382-2579
Provider Enumeration Date : 05/23/2006
Last Update Date : 12/12/2017

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