Organization
MEMPHIS VAMC
Active
Other names
Jackson VA CBOC
Organization subpart
No
Provider details
NPI number
Authorized official
ERIN POTTER (NPI TEAM MEMBER)
(202) 382-2579
Entity
Organization
Contact information
Practice address
180 OLD HICKORY BLVD, SUITE A, JACKSON, TN 38305-2562
(615) 355-3451
Mailing address
PO BOX 94511, CLEVELAND, OH 44101
(615) 355-3451
Taxonomy
Speciality
Code
Description
License number
State
261QV0200X
VA Clinic/Center
Primary
—
—
Other
Enumeration date
12/17/2008
Last updated
09/13/2017
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