NPIMap

Organization Active NPI

Martinez Vamc

  • Department of Veterans Affairs (VA) Pharmacy
  • Travis AFB, CA
National Provider Identifier
1528016649
Registry record updated Apr 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Department of Veterans Affairs (VA) PharmacyTaxonomy code 332100000X
Legal business name
MARTINEZ VAMC
Practice address
103 Bodin Cir
Travis AFB, CA 94535-1801
Phone
(707) 562-8202
NPI assigned
May 4, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2024

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

103 Bodin Cir
Travis AFB, CA 94535-1801

Mailing address

PO Box 94412
Cleveland, OH 44101-4412
Phone (702) 341-3020

Other identifiers 1

IdentifierTypeStateIssuer
5617026OtherCANCPDP#

Other names 1

  • FAIRFIELD VA CBOC PHARMACY Other name

National Provider Directory

National Provider Directory
Tax ID family
Martinez Vamc26 organizations share this tax ID, including this one

Other organizations with this tax ID 25

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

View all 25

Locations

103 Bodin Cir
Travis AFB, CA 94535
Phone (707) 437-1831

NPI Registry JSON

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

{
    "created_epoch": "1146700800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1713225600000",
    "number": "1528016649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 94412",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441014412",
            "telephone_number": "702-341-3020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 BODIN CIR",
            "city": "TRAVIS AFB",
            "state": "CA",
            "postal_code": "945351801",
            "telephone_number": "707-562-8202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARTINEZ VAMC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-04",
        "last_updated": "2024-04-16",
        "certification_date": "2024-04-16",
        "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": "5617026",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "FAIRFIELD VA CBOC PHARMACY",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Travis AFB, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2024; 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.