Organization
PRESCOTT VAMC
Active
Other names
POLACCA VA CLINIC
Organization subpart
No
Provider details
NPI number
Authorized official
ERIN POTTER (NPI TEAM MEMBER)
(202) 382-2579
Entity
Organization
Contact information
Practice address
HIGHWAY 264, MILE POST 388, POLACCA, AZ 86042-9998
(702) 341-3152
Mailing address
PO BOX 94411, CLEVELAND, OH 44101-4411
(702) 341-3152
Taxonomy
Speciality
Code
Description
License number
State
261QV0200X
VA Clinic/Center
Primary
—
—
Other
Enumeration date
07/28/2015
Last updated
11/01/2017
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