Basic Information
Provider Information
NPI: 1336198704
EntityType: 2
ReplacementNPI:  
OrganizationName: WASHINGTON DC VAMC
LastName:  
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Credential:  
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Mailing Information
Address1: PO BOX 89413
Address2:  
City: CLEVELAND
State: OH
PostalCode: 441016413
CountryCode: US
TelephoneNumber: 8282572333
FaxNumber:  
Practice Location
Address1: 50 IRVING ST NW
Address2:  
City: WASHINGTON
State: DC
PostalCode: 204220001
CountryCode: US
TelephoneNumber: 8282572333
FaxNumber:  
Other Information
ProviderEnumerationDate: 05/10/2006
LastUpdateDate: 04/13/2018
NPIDeactivationReasonCode:  
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AuthorizedOfficialLastName: POTTER
AuthorizedOfficialFirstName: ERIN
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AuthorizedOfficialTitleorPosition: NPI TEAM MEMBER
AuthorizedOfficialTelephone: 2023822579
IsSoleProprietor:  
IsOrganizationSubpart: N
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NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
282N00000X  Y HospitalsGeneral Acute Care Hospital 

No ID Information.


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