ST. LOUIS JC VAMC (NPI# 1851349062) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1851349062 |
| Entity Type | Organization |
| Organization Name | ST. LOUIS JC VAMC |
| Other Organization Name | EVANSVILLE VA CBOC PHARMACY |
| Practice Address |
6211 Waterford Blvd Evansville IN 47715-2869 |
| Mailing Address |
Po Box 94462 Cleveland OH 44101-4462 |
| Practice Telephone | 8124743670 |
| Practice Fax Number | 8124743406 |
| Mailing Telephone | 9135784409 |
| Enumeration Date | 2006-05-04 |
| Last Update Date | 2018-10-23 |
| Authorized Official Name | ERIN DENISE 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 |
|---|---|---|---|
| IN | NCPDP# | 1560095 | 01 |
| Other Name | Type Code |
|---|---|
| EVANSVILLE VA CBOC PHARMACY | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114317369 | St. Louis Jc Vamc | Clinic/Center | 2600 Washington Boulevard, St. Louis, MO 63103-1420 | 2015-01-27 |
| 1396135513 | St. Louis Jc Vamc | Clinic/Center | 3615 Olive Street, St. Louis, MO 63108-3604 | 2015-01-26 |
| 1558751776 | St. Louis Jc Vamc | Clinic/Center | 3403 Heartland Street, Marion, IL 62959-6393 | 2015-01-26 |
| 1992067995 | St. Louis Jc Vamc | Clinic/Center | 1130 E Walnut St, Suite 100, Carbondale, IL 62901-5007 | 2012-06-14 |
| 1497012652 | St. Louis Jc Vamc | Clinic/Center | 608 Rollie Moore Drive, Harrisburg, IL 62946-9998 | 2012-04-12 |
| 1902198922 | St. Louis Jc Vamc | Clinic/Center | 1627 A Roy Dr, Washington, MO 63090-5008 | 2011-05-10 |
| 1619116399 | St. Louis Jc Vamc | Clinic/Center | 1253 Paris Rd, Suite A, Mayfield, KY 42066-4989 | 2009-02-19 |
| 1518155878 | St. Louis Jc Vamc | Clinic/Center | 6854 Parker Rd, Florissant, MO 63033-5313 | 2007-10-11 |
| 1578616892 | St. Louis Jc Vamc | Clinic/Center | 99 Stagecoach Rd, Madisonville, KY 42431-8009 | 2007-01-19 |
| 1902840622 | St. Louis Jc Vamc | Clinic/Center | 4105 N Water Tower Pl, Mount Vernon, IL 62864-6296 | 2006-06-15 |
| Street Address |
6211 WATERFORD BLVD |
| City | EVANSVILLE |
| State | IN |
| Zip Code | 47715-2869 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639156904 | Charlotte J Evans | Nurse Practitioner | 6211 Waterford Blvd, Evansville, IN 47715-2869 | 2005-12-28 |
| 1154922060 | Shannon Elizabeth Callahan | Social Worker | 6211 Waterford Blvd, Evansville, IN 47715-2869 | 2020-11-06 |
| 1124628458 | Michelle Rena Mcbeath | Social Worker | 6211 Waterford Blvd, Evansville, IN 47715-2869 | 2020-10-27 |
| 1912536343 | Ashley Elizabeth Montgomery | Pharmacist | 6211 Waterford Blvd, Evansville, IN 47715-2869 | 2020-04-07 |
| 1730716440 | Olivia Golike | Social Worker | 6211 Waterford Blvd, Evansville, IN 47715-2869 | 2020-03-24 |
| 1548628639 | Christopher Meek | Social Worker | 6211 Waterford Blvd, Evansville, IN 47715-2869 | 2016-02-03 |
| 1093187080 | Toddd Matthew Young | Respiratory Therapist, Registered | 6211 Waterford Blvd, Evansville, IN 47715-2869 | 2015-10-29 |
| 1356726491 | Stephen Oakley | Social Worker | 6211 Waterford Blvd, Evansville, IN 47715-2869 | 2015-07-29 |
| 1710361456 | Lakisha Brimage | Counselor | 6211 Waterford Blvd, Evansville, IN 47715 | 2015-07-13 |
| 1881075521 | Vickie Ellis | Registered Nurse | 6211 Waterford Blvd, Evansville, IN 47715-2869 | 2015-06-17 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114528585 | Shannon Allcron | Pharmacist | 6770 E. Virginia St., Evansville, IN 47715 | 2020-11-03 |
| 1609339910 | Costco Wholesale Corporation | Eyewear Supplier (Equipment, not the service) | 1201 Cross Pointe Place, Evansville, IN 47715 | 2019-04-12 |
| 1497229223 | Hubert Family Dentistry LLP | Dentist | 6225 E Columbia St., Evansville, IN 47715 | 2019-01-15 |
| 1083110373 | Fyi Healthcare, LLC | Registered Nurse | 12000 Highway 41 North, Evansville, IN 47715 | 2018-04-04 |
| 1962862755 | New Journeys Counseling Services, LLC | Community/Behavioral Health | 4929 River Wind Pointe Drive, Evansville, IN 47715 | 2016-03-07 |
| 1558702456 | Jennifer Hoelter | Pharmacist | 5000 E Virginia St, Walgreens District Office, Evansville, IN 47715 | 2013-07-09 |
| 1952649402 | Courtney Ingold | Music Therapist | 621 E Cullen Ave, Suite 118, Evansville, IN 47715 | 2013-01-17 |
| 1922378041 | Sherry A. Fisher | Counselor | 4929 Riverwind Pointe Dr Ste 102, Evansville, IN 47715 | 2012-01-05 |
| 1710275912 | Tonja Leana Winekauf | Nurse Practitioner | 6211 E Waterford Blvd, Evansville Health Care Center, Evansville, IN 47715 | 2011-07-21 |
| 1003083437 | Allcare Dental & Dentures of In PC | Dentist | 1031 N. Green River Rd., Suite 104, Evansville, IN 47715 | 2008-05-14 |
| Find all providers in zip 47715 | ||||
| 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 |
|---|---|---|---|---|
| 1689193401 | Compass Transportation LLC | Department of Veterans Affairs (VA) Pharmacy | 2920 N Keystone Ave, Indianapolis, IN 46218-6701 | 2017-09-13 |
| 1982662789 | Indianapolis Vamc | Department of Veterans Affairs (VA) Pharmacy | 1481 West 10th Street, Indianapolis, IN 46202 | 2006-05-02 |
| 1821046848 | Chicago Vamc | Department of Veterans Affairs (VA) Pharmacy | 9301 Madison St, Crown Point, IN 46307-7745 | 2006-05-04 |
| 1457309379 | Marion Vamc | Department of Veterans Affairs (VA) Pharmacy | 1700 E 38th St, Marion, IN 46953-4568 | 2006-05-04 |
| 1427016369 | Marion Vamc | Department of Veterans Affairs (VA) Pharmacy | 2121 Lake Ave, Fort Wayne, IN 46805-5100 | 2006-05-02 |
| City | EVANSVILLE |
| Zip Code | 47715 |
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| 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.