Provider Demographics
NPI:1710037973
Name:ERIE VAMC
Entity Type:Organization
Organization Name:ERIE VAMC
Other - Org Name:FRANKLIN VA CLINIC
Other - Org Type:Other Name
Authorized Official - Title/Position:NPI TEAM MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:ERIN
Authorized Official - Middle Name:
Authorized Official - Last Name:POTTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:202-382-2579
Mailing Address - Street 1:PO BOX 94439
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44101-4439
Mailing Address - Country:US
Mailing Address - Phone:717-277-6568
Mailing Address - Fax:
Practice Address - Street 1:125 HOME DEPOT DR
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:PA
Practice Address - Zip Code:16323-8031
Practice Address - Country:US
Practice Address - Phone:717-277-6568
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-11
Last Update Date:2023-05-23
Deactivation Date:2008-03-21
Deactivation Code:
Reactivation Date:2009-06-16
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QV0200XAmbulatory Health Care FacilitiesClinic/CenterVA