Organization
MARION VAMC
Active
Other names
FORT WAYNE VAMC PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ERIN POTTER (NPI TEAM)
(202) 382-2579
Entity
Organization
Contact information
Practice address
2121 LAKE AVE, FORT WAYNE, IN 46805-5100
(800) 360-8387
(765) 677-5136
Mailing address
PO BOX 94486, CLEVELAND, OH 44101-4486
(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
—
1510735
NCPDP#
IN
Enumeration date
05/02/2006
Last updated
02/24/2023
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