# MOUNTAIN HOME VAMC

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

## Provider details

- **NPI number:** 1982236907
- **Authorized official:** ERIN DENISE POTTER (NPI LEAD)
- **Authorized official phone:** (202) 382-2579

## Contact information

- **Practice address:** 500 WASHINGTON AVE, JOHNSON CITY, TN 37604-5518
- **Practice address phone:** (615) 355-3451
- **Mailing address:** PO BOX 94516, CLEVELAND, OH 44101-4516
- **Mailing address phone:** (615) 355-3451

## Taxonomy

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

## Other

- **Enumeration date:** 02/07/2020
- **Last updated:** 02/07/2020