Provider Demographics
NPI:1003446105
Name:DURHAM VAMC
Entity Type:Organization
Organization Name:DURHAM VAMC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NPI TEAM MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:ERIN
Authorized Official - Middle Name:DENISE
Authorized Official - Last Name:POTTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:202-382-2579
Mailing Address - Street 1:PO BOX 89482
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44101-6482
Mailing Address - Country:US
Mailing Address - Phone:828-257-2333
Mailing Address - Fax:
Practice Address - Street 1:11618 US 70 BUSINESS HIGHWAY WEST
Practice Address - Street 2:SUITES 100 AND 200
Practice Address - City:CLAYTON
Practice Address - State:NC
Practice Address - Zip Code:27520-2275
Practice Address - Country:US
Practice Address - Phone:828-257-2333
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-17
Last Update Date:2020-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QV0200XAmbulatory Health Care FacilitiesClinic/CenterVA