FAYETTEVILLE VAMC (NPI# 1659547800) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1659547800 |
| Entity Type | Organization |
| Organization Name | FAYETTEVILLE VAMC |
| Other Organization Name | SPRINGFIELD VA CLINIC PHARMACY |
| Practice Address |
1850 W Republic Rd Springfield MO 65807-5730 |
| Mailing Address |
Po Box 94494 Cleveland OH 44101 |
| Practice Telephone | 4794434301 |
| Practice Fax Number | 4795875875 |
| Mailing Telephone | 6153553451 |
| Enumeration Date | 2008-05-07 |
| Last Update Date | 2019-02-12 |
| Authorized Official Name | ERIN POTTER (NPI TEAM MEMBER) |
| Authorized Official Telephone | 2023822579 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332100000X | Department of Veterans Affairs (VA) Pharmacy | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | NCPDP | 2636263 | 01 |
| Other Name | Type Code |
|---|---|
| SPRINGFIELD VA CLINIC PHARMACY | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992264824 | Fayetteville Vamc | Clinic/Center | 3015 Connecticut Ave, Joplin, MO 64804-3035 | 2019-03-19 |
| 1659879138 | Fayetteville Vamc | Clinic/Center | 4 Josh Ct, Jacksonville, NC 28546-0052 | 2018-01-30 |
| 1194256362 | Fayetteville Vamc | Clinic/Center | 4101 Raeford Road, Suite 100-b, Fayetteville, NC 28304-4114 | 2017-03-21 |
| 1528456811 | Fayetteville Vamc | Clinic/Center | 216 East Township Street, Fayetteville, AR 72703-2818 | 2015-01-08 |
| 1124422308 | Fayetteville Vamc | Clinic/Center | 306 Brynn Marr Rd, Jacksonville, NC 28546-7023 | 2014-10-16 |
| 1962819052 | Fayetteville Vamc | Clinic/Center | 18 Doctors Cir Ste 2, Supply, NC 28462-4089 | 2014-07-21 |
| 1114270212 | Fayetteville Vamc | Clinic/Center | 3112 Tramway Road, Sanford, NC 27332-9998 | 2012-10-26 |
| 1912201146 | Fayetteville Vamc | Clinic/Center | 139 Three Hunts Drive, Pembroke, NC 28372-6800 | 2011-01-03 |
| 1831415751 | Fayetteville Vamc | Clinic/Center | 2713 W Commercial St, Ozark, AR 72949-3409 | 2010-04-16 |
| 1568417798 | Fayetteville Vamc | Clinic/Center | 4006 Henderson Drive, Jacksonville, NC 28546-9998 | 2006-05-24 |
| Street Address |
1850 W REPUBLIC RD |
| City | SPRINGFIELD |
| State | MO |
| Zip Code | 65807-5730 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609856483 | Keith David Eiche | Psychologist | 1850 W Republic Rd, Springfield, MO 65807-5730 | 2006-01-18 |
| 1275154106 | Tyler Thill | Optometrist | 1850 W Republic Rd, Springfield, MO 65807-5730 | 2020-05-01 |
| 1821555368 | James Quentin Walsh | Social Worker | 1850 W Republic Rd, Springfield, MO 65807-5730 | 2019-02-20 |
| 1902254063 | Brittany Lynn Setzer | Optometrist | 1850 W Republic Rd, Springfield, MO 65807-5730 | 2016-05-31 |
| 1124430988 | Hilary Morrow Price | Optometrist | 1850 W Republic Rd, Springfield, MO 65807-5730 | 2014-05-28 |
| 1821297698 | Gretta Lynn Gilliam | Nurse Practitioner | 1850 W Republic Rd, Springfield, MO 65807-5730 | 2007-07-12 |
| 1417900671 | Fayetteville Vamc | Clinic/Center | 1850 W Republic Rd, Springfield, MO 65807-5730 | 2006-05-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396390241 | Karley Kassandra Murphy | Counselor | 3734 South Ave #c, Springfield, MO 65807 | 2019-08-07 |
| 1396203626 | Auvia L Logan | Dietitian, Registered | 3322 S. Campbell Ave. Suite Cc, Springfield, MO 65807 | 2019-03-05 |
| 1598250961 | Kathryn Barber | Nurse Practitioner | 3800 S National Ave Ste 700, Springfield, MO 65807 | 2018-06-27 |
| 1447764899 | Missouri Midwifery Service | Clinic/Center | 3840 South Avenue, Springfield, MO 65807 | 2017-11-21 |
| 1124530290 | Senior Living Management Group, LLC | Skilled Nursing Facility | 3705 S Jefferson Ave, Springfield, MO 65807 | 2017-10-30 |
| 1740663335 | Sarah E Kirk | Physical Therapist | 3545 S. National Ave, Springfield, MO 65807 | 2015-07-01 |
| 1750713335 | Amanda Ward | Nurse Practitioner | 2150 W Republic Rd Ste 112, Springfield, MO 65807 | 2013-08-06 |
| 1932531126 | Eugenia R Cortez | Counselor | 2124 Chesterfield Blvd., Springfield, MO 65807 | 2013-07-30 |
| 1962742866 | Missouri Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 3045 W Republic St, Springfield, MO 65807 | 2013-03-01 |
| 1033462387 | Miguel Angel Medina | Physician Assistant | 1900 South Sunshine Ave., Springfield, MO 65807 | 2012-10-24 |
| Find all providers in zip 65807 | ||||
| Taxonomy Code | 332100000X |
| Grouping | Suppliers |
| Classification | Department of Veterans Affairs (VA) Pharmacy |
| Department of Veterans Affairs (VA) Pharmacy means any place under VA jurisdiction where drugs are dispensed and Pharmaceutical Care is provided to enrolled Veterans, by licensed pharmacists. The Pharmacy is reviewed by JCAHO, utilizes the VA hospital’s DEA number, and has a designated NCPDP number. VA facility pharmacies include Inpatient (Institutional), Outpatient, Consolidated Mail Outpatient Pharmacies (CMOPs), Research, Addiction Treatment Centers, Long Term Care and Community Based Outpatient Clinics Pharmacies. The VHA Pharmacy Benefits Management - Strategic Healthcare Group has oversight for professional and practice activities of VA Pharmacies. Each pharmacy is under the direct supervision of a U.S. or U.S. territory licensed pharmacist, and has staffing to meet its designated scope of service. |
| Notes: Source: Pharmacy Benefits Management – Strategic Healthcare Group, Veterans Health Administration, Department of Veterans Affairs [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013965896 | Northampton Vamc | Department of Veterans Affairs (VA) Pharmacy | 25 Bond St, Springfield, MA 01104-3401 | 2006-05-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366824351 | Walgreens Pharmacy | Department of Veterans Affairs (VA) Pharmacy | 12345 Saint Charles Rock Rd, Bridgeton, MO 63044-2505 | 2015-06-25 |
| 1912180357 | St. Louis Jc Vamc | Department of Veterans Affairs (VA) Pharmacy | 915 N Grand Blvd, Saint Louis, MO 63106-1621 | 2007-12-07 |
| 1558319715 | St. Louis Jc Vamc | Department of Veterans Affairs (VA) Pharmacy | 1 Jefferson Barracks Dr, Saint Louis, MO 63125-4181 | 2006-05-04 |
| 1588622880 | St. Louis Jc Vamc | Department of Veterans Affairs (VA) Pharmacy | 1500 N Westwood Blvd, Poplar Bluff, MO 63901-3318 | 2006-05-03 |
| 1194783001 | Kansas City Vamc | Department of Veterans Affairs (VA) Pharmacy | 800 Hospital Dr, Columbia, MO 65201-5275 | 2006-05-02 |
| 1326006149 | Kansas City Vamc | Department of Veterans Affairs (VA) Pharmacy | 4801 E Linwood Blvd, Kansas City, MO 64128-2226 | 2006-05-02 |
| City | SPRINGFIELD |
| Zip Code | 65807 |
Please comment or provide details below to improve the information on FAYETTEVILLE VAMC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.