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NPI Code Detail

MEDICARE: LAS VEGAS VAMC

MEDICARE: LAS VEGAS 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 : 1609159292
Entity Type Code : Organization
Provider Name (Legal Business Name) : LAS VEGAS VAMC
Provider Business Mailing Address
First Line : PO BOX 94408
Second Line :
City : CLEVELAND
State : OH
Zip : 44101-4408
Country : US
Telephone Number : 702-341-3020
Fax Number :
Provider Business Practice Location Address
First Line : 3968 N RANCHO DRIVE
Second Line :
City : LAS VEGAS
State : NV
Zip : 89130-3412
Country : US
Telephone Number : 702-341-3020
Fax Number :
Authorized Official
Title or Position : NPI TEAM MEMBER
Name : MS. ERIN POTTER
Credential :
Telephone Number : 202-382-2579
Provider Enumeration Date : 09/21/2011
Last Update Date : 10/31/2017

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Directions to “LAS VEGAS VAMC ” Practice Location

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