Organization Name: | FARGO VAMC |
NPI Number: | 1023426913 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | ERIN POTTER (NPI TEAM MEMBER) |
Mailing Address: | 528 21st St W Suite F Dickinson |
State: | ND US |
Postal Code: | 586012661 |
Phone Number: | 9135784110 |
Fax Number: | |
NPI Enumeration Date: | 07/24/2014 |
NPI Last Update Date: | 07/24/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QV0200X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | VA |
Taxonomy Definition: |