NPIMap

Organization Active NPI

Marion Vamc

  • Department of Veterans Affairs (VA) Pharmacy
  • Fort Wayne, IN
National Provider Identifier
1427016369
Registry record updated Feb 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Department of Veterans Affairs (VA) PharmacyTaxonomy code 332100000X
Legal business name
MARION VAMC
Practice address
2121 Lake Ave
Fort Wayne, IN 46805-5100
Phone
(800) 360-8387
Fax
(765) 677-5136
NPI assigned
May 2, 2006
Last updated
Feb 24, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2023

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

Authorized official

Name
Ms. Erin Potter
Title
Npi Team
Phone
(202) 382-2579

Specialties & licenses 1

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

Addresses

Primary practice location

2121 Lake Ave
Fort Wayne, IN 46805-5100

Mailing address

PO Box 94486
Cleveland, OH 44101-4486
Phone (608) 821-7200

Other identifiers 1

IdentifierTypeStateIssuer
1510735OtherINNCPDP#

Other names 1

  • FORT WAYNE VAMC PHARMACY Other name

National Provider Directory

National Provider Directory
Tax ID family
Marion Vamc11 organizations share this tax ID, including this one

Other organizations with this tax ID 10

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

NPI Registry JSON

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

{
    "created_epoch": "1146528000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1677196800000",
    "number": "1427016369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 94486",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441014486",
            "telephone_number": "608-821-7200",
            "fax_number": "608-821-7658"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2121 LAKE AVE",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468055100",
            "telephone_number": "800-360-8387",
            "fax_number": "765-677-5136"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARION VAMC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-02",
        "last_updated": "2023-02-24",
        "certification_date": "2023-02-24",
        "status": "A",
        "authorized_official_last_name": "POTTER",
        "authorized_official_first_name": "ERIN",
        "authorized_official_title_or_position": "NPI TEAM",
        "authorized_official_telephone_number": "202-382-2579",
        "authorized_official_name_prefix": "Ms."
    },
    "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": "1510735",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "FORT WAYNE VAMC PHARMACY",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Fort Wayne, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2023; 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.