Organization
PROVIDENCE VAMC
Active
Other names
PROVIDENCE VAMC PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
ERIN DENISE POTTER (NPI TEAM)
(202) 382-2579
Entity
Organization
Contact information
Practice address
830 CHALKSTONE AVE, PROVIDENCE, RI 02908-4734
(401) 273-7100
(401) 457-1421
Mailing address
PO BOX 94448, CLEVELAND, OH 44101-4448
(717) 277-6565
Taxonomy
Speciality
Code
Description
License number
State
332100000X
Department of Veterans Affairs (VA) Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4106349
NCPDP#
RI
Enumeration date
05/03/2006
Last updated
09/25/2023
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