Organization
PROVIDENCE VAMC
Active
Other names
PROVIDENCE VA CLINIC
Organization subpart
No
Provider details
NPI number
Authorized official
ERIN DENISE POTTER (NPI TEAM MEMBER)
(202) 382-2579
Entity
Organization
Contact information
Practice address
75 EAGLE ST, PROVIDENCE, RI 02909-1081
(717) 277-6565
Mailing address
PO BOX 94448, CLEVELAND, OH 44101-4448
(717) 277-6565
Taxonomy
Speciality
Code
Description
License number
State
261QV0200X
VA Clinic/Center
Primary
—
—
Other
Enumeration date
09/20/2018
Last updated
01/10/2023
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