Provider Demographics
NPI:1538421110
Name:DEPARTMENT OF VETERANS AFFAIRS MEDS BY MAIL
Entity type:Organization
Organization Name:DEPARTMENT OF VETERANS AFFAIRS MEDS BY MAIL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EBILLING PROJECT MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:
Authorized Official - Last Name:DUNCAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:202-382-2579
Mailing Address - Street 1:PO BOX 20330
Mailing Address - Street 2:
Mailing Address - City:CHEYENNE
Mailing Address - State:WY
Mailing Address - Zip Code:82003-7033
Mailing Address - Country:US
Mailing Address - Phone:478-274-5534
Mailing Address - Fax:478-274-5536
Practice Address - Street 1:5353 YELLOWSTONE RD
Practice Address - Street 2:
Practice Address - City:CHEYENNE
Practice Address - State:WY
Practice Address - Zip Code:82009-4178
Practice Address - Country:US
Practice Address - Phone:478-274-5534
Practice Address - Fax:478-274-5536
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-11
Last Update Date:2013-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332100000XSuppliersDepartment of Veterans Affairs (VA) Pharmacy