Organization
SAN JUAN VAMC
Active
Other names
MAYAGUEZ VA CLINIC PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
ERIN POTTER (NPI TEAM MEMBER)
(202) 382-2579
Entity
Organization
Contact information
Practice address
175 AVE ALGARROBO, MAYAGUEZ, PR 00682-6331
(787) 641-7582
(787) 522-2988
Mailing address
PO BOX 94469, CLEVELAND, OH 44101-4469
(866) 793-4591
Taxonomy
Speciality
Code
Description
License number
State
332100000X
Department of Veterans Affairs (VA) Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4024016
NCPDP
PR
Enumeration date
05/03/2006
Last updated
03/28/2023
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