Organization
DANVILLE VAMC
Active
Other names
PEORIA VA CLINIC PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
ERIN DENISE POTTER (NPI TEAM)
(202) 382-2579
Entity
Organization
Contact information
Practice address
7717 N ORANGE PRAIRIE RD, PEORIA, IL 61615-9323
(309) 589-6800
(309) 589-6996
Mailing address
PO BOX 94478, CLEVELAND, OH 44101-4478
(608) 821-7200
(608) 821-7658
Taxonomy
Speciality
Code
Description
License number
State
332100000X
Department of Veterans Affairs (VA) Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1476313
NCPDP#
IL
Enumeration date
05/04/2006
Last updated
09/25/2023
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