Organization
MOUNTAIN HOME VAMC
Active
Organization
MOUNTAIN HOME VAMC
Active
Other names
MOUNTAIN HOME VAMC PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
ERIN POTTER (NPI TEAM MEMBER)
(202) 382-2579
Entity
Organization
Contact information
Practice address
1 VETERANS WAY, MOUNTAIN HOME, TN 37684-9998
(423) 979-3434
(423) 979-3019
Mailing address
PO BOX 94516, 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
—
4436540
NCPDP#
TN
Enumeration date
05/05/2006
Last updated
06/03/2022
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