Organization
JACKSON VAMC
Active
Other names
JACKSON VAMC PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
ERIN POTTER (NPI TEAM)
(202) 382-2579
Entity
Organization
Contact information
Practice address
1500 E WOODROW WILSON AVE, JACKSON, MS 39216-5116
(601) 364-1297
(601) 368-4006
Mailing address
PO BOX 94497, CLEVELAND, OH 44101-4497
(615) 355-3451
Taxonomy
Speciality
Code
Description
License number
State
332100000X
Department of Veterans Affairs (VA) Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2508995
NCPDP#
MS
Enumeration date
05/02/2006
Last updated
08/12/2024
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