Organization
LOMA LINDA VAMC
Active
Other names
LOMA LINDA VAMC PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
ERIN POTTER (NPI TEAM MEMBER)
(202) 382-2579
Entity
Organization
Contact information
Practice address
11201 BENTON ST, LOMA LINDA, CA 92357-1000
(909) 825-7084
(909) 422-3017
Mailing address
PO BOX 94409, CLEVELAND, OH 44101-4409
(702) 341-3152
Taxonomy
Speciality
Code
Description
License number
State
332100000X
Department of Veterans Affairs (VA) Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0569333
NCPDP#
CA
Enumeration date
05/02/2006
Last updated
10/23/2018
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