Prescott Vamc
Organization Active NPI VA Clinic/Center · Polacca, AZ
NPI 1669857975 · NPPES record last updated Nov 1, 2017
Key facts
- NPI
- 1669857975
- Entity type
- Organization (NPI type 2)
- Primary specialty
- VA Clinic/Center 261QV0200X
- Legal business name
- PRESCOTT VAMC
- Practice address
- Highway 264
Mile Post 388
Polacca, AZ 86042-9998 - Phone
- (702) 341-3152
- NPI assigned
- Jul 28, 2015
- Organization subpart
- No
Authorized official
- Name
- Erin Potter
- Title
- Npi Team Member
- Phone
- (202) 382-2579
Corporate family (same tax ID) 12
National Provider Directory
- Tax ID family
- Prescott Vamc
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| VA Clinic/Center | 261QV0200X | Yes |
Addresses
Primary practice location
Highway 264
Mile Post 388
Polacca, AZ 86042-9998
Mailing address
PO Box 94411
Cleveland, OH 44101-4411
Phone (702) 341-3152
Other names
- POLACCA VA CLINIC
Other providers in Polacca, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 1, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.