Organization
WEST LOS ANGELES VAMC
Active
Other names
WEST LA VAMC - METHADONE PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
ERIN DENISE POTTER (NPI TEAM MEMBER)
(202) 382-2579
Entity
Organization
Contact information
Practice address
11301 WILSHIRE BLVD, LOS ANGELES, CA 90073-1003
(310) 268-3152
(310) 268-4959
Mailing address
PO BOX 94424, CLEVELAND, OH 44101-4424
(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
—
0521965
NCPDP#
CA
Enumeration date
05/05/2006
Last updated
04/06/2018
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