Organization
BOISE VAMC
Active
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 W FORT ST, BOISE, ID 83702-4501
(208) 422-1000
(208) 422-1198
Mailing address
PO BOX 94402, CLEVELAND, OH 44101-4402
(702) 341-3164
Taxonomy
Speciality
Code
Description
License number
State
332100000X
Department of Veterans Affairs (VA) Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1305766
NCPDP#
ID
Enumeration date
05/01/2006
Last updated
03/29/2018
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