NPIMap

Organization Active NPI

Portland Vamc

  • Department of Veterans Affairs (VA) Pharmacy
  • Portland, OR
National Provider Identifier
1306804588
Registry record updated May 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Department of Veterans Affairs (VA) PharmacyTaxonomy code 332100000X
Legal business name
PORTLAND VAMC
Practice address
3710 SW US Veterans Hospital Rd
Portland, OR 97239-2964
Phone
(360) 696-4061
Fax
(360) 905-1767
NPI assigned
May 3, 2006
Last updated
May 24, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 24, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Erin Denise Potter
Title
Npi Team Member
Phone
(202) 382-2579

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Department of Veterans Affairs (VA) Pharmacy 332100000X Primary

Addresses

Primary practice location

3710 SW US Veterans Hospital Rd
Portland, OR 97239-2964

Mailing address

PO Box 94414
Cleveland, OH 44101-4414
Phone (702) 341-3164

Other identifiers 1

IdentifierTypeStateIssuer
3804007OtherORNCPDP#

Other names 1

  • PORTLAND VAMC PHARMACY Other name

National Provider Directory

National Provider Directory
Tax ID family
Portland Vamc16 organizations share this tax ID, including this one

Other organizations with this tax ID 15

Organizations that report the same tax identification number in the National Provider Directory.

View all 15

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1146614400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1653350400000",
    "number": "1306804588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 94414",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441014414",
            "telephone_number": "702-341-3164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3710 SW US VETERANS HOSPITAL RD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972392964",
            "telephone_number": "360-696-4061",
            "fax_number": "360-905-1767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PORTLAND VAMC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-03",
        "last_updated": "2022-05-24",
        "certification_date": "2022-05-24",
        "status": "A",
        "authorized_official_last_name": "POTTER",
        "authorized_official_first_name": "ERIN",
        "authorized_official_middle_name": "DENISE",
        "authorized_official_title_or_position": "NPI TEAM MEMBER",
        "authorized_official_telephone_number": "202-382-2579"
    },
    "taxonomies": [
        {
            "code": "332100000X",
            "taxonomy_group": "",
            "desc": "Department of Veterans Affairs (VA) Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP#",
            "identifier": "3804007",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PORTLAND VAMC PHARMACY",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Portland, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.