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Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
VA |
261QV0200X |
| NPI Number | 1700824646 |
| LBN Legal business name | MOUNTAIN HOME VAMC |
| Authorized official | ERIN POTTER - (NPI TEAM MEMBER) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | 06/03/2006 |
| Last updated | 09/07/2017 - About 9 years ago |
| Identifiers | n/a |
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MOUNTAIN HOME VAMC
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MOUNTAIN HOME VAMC