Organization
SALT LAKE CITY VAMC
Active
Other names
SALT LAKE CITY VAMC 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
500 FOOTHILL BLVD, SALT LAKE CITY, UT 84148-0001
(801) 582-1565
(801) 584-2530
Mailing address
PO BOX 94463, CLEVELAND, OH 44101-4463
(913) 578-4409
Taxonomy
Speciality
Code
Description
License number
State
332100000X
Department of Veterans Affairs (VA) Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4608658
NCPDP#
UT
Enumeration date
05/03/2006
Last updated
10/24/2018
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