FAYETTEVILLE VAMC


Address: 1705 Gardner Road, Wilmington, NC 28405-8873
Phone: 9103435300

FAYETTEVILLE VAMC (NPI# 1831438381) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1831438381
Entity Type Organization
Organization Name FAYETTEVILLE VAMC
Other Organization Name WILMINGTON NC VA CLINIC PHARMACY
Practice Address 1705 Gardner Road
Wilmington
NC 28405-8873
Mailing Address Po Box 89494
Cleveland
OH 44101-6494
Practice Telephone 9103435300
Practice Fax Number 9102544055
Mailing Telephone 8282572333
Enumeration Date 2013-02-04
Last Update Date 2020-07-01
Authorized Official Name ERIN DENISE POTTER (NPI TEAM MEMBER)
Authorized Official Telephone 2023822579
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 332100000X Department of Veterans Affairs (VA) Pharmacy Suppliers

Other Provider Identifier

State Issuer Identifier Type Code
NCPDP 3461403 01

Other Provider/Organization Names

Other Name Type Code
WILMINGTON NC VA CLINIC PHARMACY Other Name - Individual/Organization
WILMINGTON VA CBOC PHARMACY Other Name - Individual/Organization

Other Provider IDs and Locations

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

Office Location

Street Address 1705 GARDNER ROAD
City WILMINGTON
State NC
Zip Code 28405-8873

Providers in the same location

NPI Name Taxonomy Address Enumeration
1578548160 Andrew J Vitt Pharmacist 1705 Gardner Road, Veterans Affairs Health Care Center, Wilmington, NC 28405 2005-12-07
1124487319 Vamc 565 Wilmington Hcc Clinic/Center 1705 Gardner Road, Va Pharmacy, Wilmington, NC 28405 2016-02-16
1477998854 Justin Daniel Le Duc Social Worker 1705 Gardner Road, Wilmington, NC 28405-8075 2013-04-30
1043253156 Fayetteville Vamc Clinic/Center 1705 Gardner Road, Wilmington, NC 28405-8873 2006-06-14

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1376155507 Evan Michael Vallee Dentist 5023 Market Street Wilmington, Wilmington, NC 28405 2020-08-19
1447725098 Addictioncare 101 Psychiatry & Neurology 311 4 E Judges Road, Wilmington, NC 28405 2018-10-10
1659861649 Brianna Jane Gausman Physical Therapist 6752 Parker Farm Dr Ste 1b, Wilmington, NC 28405 2018-05-15
1205346756 Good Night Medical of Ohio, LLC Durable Medical Equipment & Medical Supplies 6427a Windmill Way, Wilmington, NC 28405 2017-10-10
1710345400 Martha Arielle Walker Physician Assistant 6727 Parker Farm Dr, Wilmington, NC 28405 2016-02-09
1033549910 Christine Urban Bruin Psychologist 510 Military Cutoff Rd., Suite 120, Wilmington, NC 28405 2013-11-14
1487083358 Aci Support Specialists Day Training, Developmentally Disabled Services 117 Spartan Road, Wilmington, NC 28405 2013-11-01
1487902334 Carolina Vision Associates, Od, Pa Optometrist 5301 B Market St, Carolina Vison Associates, Od, Pa, Wilmington, NC 28405 2012-08-27
1568718328 Cameron Nichole Ford Occupational Therapy Assistant 5004 Hunters Trl, Apt 5, Wilmington, NC 28405 2012-07-31
1881959534 Ashley Brennen Cook Speech-Language Pathologist 4613 Trafalgar Rd, Wilmington, NC 28405 2012-07-09
Find all providers in zip 28405

Taxonomy Information

Taxonomy Code 332100000X
Grouping Suppliers
Classification Department of Veterans Affairs (VA) Pharmacy

Taxonomy Definition

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]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1003864208 Wilmington Vamc Department of Veterans Affairs (VA) Pharmacy 1601 Kirkwood Hwy, Wilmington, DE 19805-4917 2006-05-04

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1245693050 Salisbury Vamc Department of Veterans Affairs (VA) Pharmacy 3506 W Tyvola Road, Charlotte, NC 28208 2016-03-30
1699146019 Fayetteville Vamc Department of Veterans Affairs (VA) Pharmacy 7300 S Raeford Rd, Fayetteville, NC 28304-6162 2015-10-12
1225432248 Durham Vamc Department of Veterans Affairs (VA) Pharmacy 401 Moye Blvd, Greenville, NC 27834-2885 2014-10-20
1912162330 Salisbury Vamc Department of Veterans Affairs (VA) Pharmacy 8601 University East Dr, Charlotte, NC 28213 2008-07-24
1922056555 Salisbury Vamc Department of Veterans Affairs (VA) Pharmacy 1601 Brenner Ave, Salisbury, NC 28144-2515 2006-05-05
1982652723 Salisbury Vamc Department of Veterans Affairs (VA) Pharmacy 1695 Kernersville Medical Pkwy, Kernersville, NC 27284 2006-05-04
1952369886 Durham Vamc Department of Veterans Affairs (VA) Pharmacy 508 Fulton St, Durham, NC 27705-3875 2006-05-02
1871551713 Fayetteville Vamc Department of Veterans Affairs (VA) Pharmacy 2300 Ramsey St, Fayetteville, NC 28301-3856 2006-05-02
1417914508 Asheville Vamc Department of Veterans Affairs (VA) Pharmacy 1100 Tunnel Rd, Asheville, NC 28805 2006-05-01

Competitor

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City WILMINGTON
Zip Code 28405

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Dataset Information

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.

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