Organization
GAINESVILLE VAMC
Active
Other names
JACKSONVILLE VA CLINIC PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ERIN POTTER (NPI TEAM MEMBER)
(202) 382-2579
Entity
Organization
Contact information
Practice address
1536 N JEFFERSON ST, JACKSONVILLE, FL 32209-6525
(904) 475-6092
(904) 232-2382
Mailing address
PO BOX 140794, ORLANDO, FL 32814-0794
(407) 622-4142
Taxonomy
Speciality
Code
Description
License number
State
332100000X
Department of Veterans Affairs (VA) Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1099008
NCPDP#
FL
Enumeration date
05/04/2006
Last updated
02/23/2022
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