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NPI Code Detail

MEDICARE: MARTINEZ VAMC

MEDICARE: MARTINEZ 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
15617002OTHERCANCPDP#

General Provider Information

NPI Number : 1780632901
Entity Type Code : Organization
Provider Name (Legal Business Name) : MARTINEZ VAMC
Provider Business Mailing Address
First Line : PO BOX 94412
Second Line :
City : CLEVELAND
State : OH
Zip : 44101-4412
Country : US
Telephone Number : 702-341-3020
Fax Number :
Provider Business Practice Location Address
First Line : 201 WALNUT AVE
Second Line :
City : VALLEJO
State : CA
Zip : 94592-1107
Country : US
Telephone Number : 707-562-8202
Fax Number :
Authorized Official
Title or Position : NPI TEAM MEMBER
Name : MS. ERIN POTTER
Credential :
Telephone Number : 202-382-2579
Provider Enumeration Date : 05/04/2006
Last Update Date : 04/04/2018

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Directions to “MARTINEZ VAMC ” Practice Location

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