Organization
FARGO VAMC
Active
Other names
FARGO 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
2101 ELM ST N, FARGO, ND 58102-2417
(701) 232-3241
(701) 239-3704
Mailing address
PO BOX 94452, CLEVELAND, OH 44101-4452
(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
—
3504063
NCPDP#
ND
Enumeration date
05/02/2006
Last updated
10/23/2018
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