MANCHESTER VAMC (NPI# 1255399838) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255399838 |
| Entity Type | Organization |
| Organization Name | MANCHESTER VAMC |
| Other Organization Name | MANCHESTER VAMC PHARMACY |
| Practice Address |
718 Smyth Road Manchester NH 03104-7004 |
| Mailing Address |
Po Box 3019 Lebanon PA 17042-3019 |
| Practice Telephone | 6036244366 |
| Practice Fax Number | 6036266562 |
| Mailing Telephone | 7172776565 |
| Enumeration Date | 2006-05-03 |
| Last Update Date | 2018-10-24 |
| 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 |
|---|---|---|---|
| NH | NCPDP# | 3005255 | 01 |
| Other Name | Type Code |
|---|---|
| MANCHESTER VAMC PHARMACY | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154487585 | Manchester Vamc | Clinic/Center | 5 Terrascape Pkwy, Somersworth, NH 03878-1115 | 2006-12-29 |
| 1215989363 | Manchester Vamc | Clinic/Center | 71 Hobbs St, Conway, NH 03818-8109 | 2006-05-17 |
| 1477653731 | Manchester Vamc | General Acute Care Hospital | 718 Smyth Rd, Manchester, NH 03104-7004 | 2006-09-25 |
| 1699716035 | Manchester Vamc | Clinic/Center | 630 W Main St, Suite 400, Tilton, NH 03276-5034 | 2006-06-09 |
| 1861439101 | Manchester Vamc | Clinic/Center | 302 Newmarket St, Building 15, Pease Air National Guard Base, Portsmouth, NH 03803-0001 | 2006-06-02 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | MANCHESTER VAMC #608 | 718 Smyth Rd, Manchester, NH 03104-7007 |
| Street Address |
718 SMYTH ROAD |
| City | MANCHESTER |
| State | NH |
| Zip Code | 03104-7004 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558722421 | Shelby Evans | Licensed Practical Nurse | 718 Smyth Road, Manchester, NH 03104 | 2016-03-18 |
| 1699026179 | Jessica Amy Snyder | Nurse Practitioner | 718 Smyth Road, Manchester, MA 03104 | 2012-09-25 |
| 1275694523 | Beverly Anne Morshed | Speech-Language Pathologist | 718 Smyth Road, Manchester, NH 03104 | 2006-12-12 |
| 1376638148 | Thomas A. Bonito | Pharmacist | 718 Smyth Road, Va Medical Center, Manchester, NH 03104 | 2006-10-04 |
| 1750476131 | Linda Robeck Horton | Pharmacist | 718 Smyth Road, Manchester, NH 03104 | 2006-10-03 |
| 1326130907 | Mark Wayne Gilbertson | Psychologist | 718 Smyth Road, Manchester, NH 03104 | 2006-09-29 |
| 1891891065 | Linda Elizabeth Geraci | Internal Medicine | 718 Smyth Road, Manchester Va Medical Center, Manchester, NH 03104 | 2006-09-15 |
| 1336243468 | Kathleen K Jensen | Social Worker | 718 Smyth Road, Manchester, NH 03104 | 2006-09-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730675562 | Hannah E Boutselis | Nurse Practitioner | 1750 Elm St., Suite 201a, Manchester, NH 03104 | 2018-07-04 |
| 1366948770 | Families In Transition | Counselor | 15 Brook St, Manchester, NH 03104 | 2018-04-04 |
| 1528586872 | Nicole Mitchell | Physical Therapy Assistant | 235 Myrtle St., Manchester, NH 03104 | 2017-09-07 |
| 1851819270 | Community House Calls LLC | Contractor | 497 Hooksett Road, 232, Manchester, NH 03104 | 2017-09-06 |
| 1407207533 | Brianna Cassidy | Specialist/Technologist | 62 Jonathan Ln, Manchester, NH 03104 | 2016-06-30 |
| 1477926871 | Anthony Macri | Skilled Nursing Facility | 524 Blevens Dr., Manchester, NH 03104 | 2015-11-06 |
| 1225412935 | Families In Transition | Counselor | 136 Lowell St, Manchester, NH 03104 | 2015-07-13 |
| 1386036622 | Phoenix Rising Counseling Services, LLC | Counselor | 114 Bay Street, Suite A, Manchester, NH 03104 | 2015-02-24 |
| 1366795767 | Alicia M. Kleczkowski | Nurse Practitioner | 57 Webster St., Manchester, NH 03104 | 2012-10-23 |
| 1356615710 | Laurie Lagasse | Physical Therapy Assistant | 44 West Webster St, Manchester, NH 03104 | 2012-03-02 |
| Find all providers in zip 03104 | ||||
| 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] |
| City | MANCHESTER |
| Zip Code | 03104 |
Please comment or provide details below to improve the information on MANCHESTER 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.