| Organization Name: | SALT LAKE CITY VAMC |
| NPI Number: | 1124419551 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | ERIN POTTER (NPI TEAM MEMBER) |
| Mailing Address: | 189 S 600 W Suite B Price |
| State: | UT US |
| Postal Code: | 845012833 |
| Phone Number: | 9135784110 |
| Fax Number: | |
| NPI Enumeration Date: | 02/06/2015 |
| NPI Last Update Date: | 08/25/2015 |
| 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: | |