# BOISE VAMC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** HINES VA CLINIC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1548677602
- **Authorized official:** ERIN POTTER (NPI TEAM MEMBER)
- **Authorized official phone:** (202) 382-2579

## Contact information

- **Practice address:** 635 HIGHWAY 20 N STE 4, HINES, OR 97738-9462
- **Practice address phone:** (702) 341-3164
- **Mailing address:** PO BOX 94402, CLEVELAND, OH 44101-4402
- **Mailing address phone:** (702) 341-3164

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QV0200X | VA Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 07/21/2014
- **Last updated:** 07/29/2020