MEDICARE: VETERANS AFAIRS OUTPATIENT C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QV0200X	VA Clinic/Center		AK

General Provider Information

NPI Number	:	1689880247
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VETERANS AFAIRS OUTPATIENT C

Provider Business Mailing Address
First Line	:	15701 ROBIN HOOD DR
Second Line	:
City	:	ANCHORAGE
State	:	AK
Zip	:	99516-5010
Country	:	US
Telephone Number	:	907-345-5700
Fax Number	:

Provider Business Practice Location Address
First Line	:	15701 ROBIN HOOD DR
Second Line	:
City	:	ANCHORAGE
State	:	AK
Zip	:	99516-5010
Country	:	US
Telephone Number	:	907-345-5700
Fax Number	:

Authorized Official
Title or Position	:	STAFF CLERK
Name	:	THERESA L. MORSE
Credential	:
Telephone Number	:	907-257-4750

Provider Enumeration Date	:	05/14/2007
Last Update Date	:	08/22/2020

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