Organization
DALLAS VAMC
Active
Other names
FORT WORTH 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
2201 SE LOOP 820, FORT WORTH, TX 76119-5863
(817) 730-0000
(817) 730-0418
Mailing address
PO BOX 94493, CLEVELAND, OH 44101
(615) 355-3451
Taxonomy
Speciality
Code
Description
License number
State
332100000X
Department of Veterans Affairs (VA) Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4518316
NCPDP#
TX
Enumeration date
05/02/2006
Last updated
10/24/2018
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