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NPI Code Detail

MEDICARE: OMAHA VAMC

MEDICARE: OMAHA 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
12816912OTHERNENCPDP#

General Provider Information

NPI Number : 1841258720
Entity Type Code : Organization
Provider Name (Legal Business Name) : OMAHA VAMC
Provider Business Mailing Address
First Line : PO BOX 94460
Second Line :
City : CLEVELAND
State : OH
Zip : 44101-4460
Country : US
Telephone Number : 913-578-4409
Fax Number :
Provider Business Practice Location Address
First Line : 2201 N BROADWELL AVE
Second Line :
City : GRAND ISLAND
State : NE
Zip : 68803-2153
Country : US
Telephone Number : 308-382-3660
Fax Number : 308-389-5161
Authorized Official
Title or Position : NPI TEAM MEMBER
Name : ERIN DENISE POTTER
Credential :
Telephone Number : 202-382-2579
Provider Enumeration Date : 05/02/2006
Last Update Date : 10/25/2018

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Directions to “OMAHA VAMC ” Practice Location

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