Healthcare Provider Details

I. General information

NPI: 1851563613
Provider Name (Legal Business Name): DEPARTMENT OF VETERAN AFFAIRS CENTRAL ALABAMA VETERANS HEALTH CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/01/2008
Last Update Date: 04/01/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2400 HOSPITAL RD
TUSKEGEE AL
36083-5001
US

IV. Provider business mailing address

2400 HOSPITAL RD
TUSKEGEE AL
36083-5001
US

V. Phone/Fax

Practice location:
  • Phone: 334-727-0807
  • Fax:
Mailing address:
  • Phone: 334-727-0807
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2865M2000X
TaxonomyMilitary General Acute Care Hospital
License Number1038489
License Number StateAL

VIII. Authorized Official

Name: DR. ROBERT RATLIFF
Title or Position: DIRECTOR
Credential: PHD,FACHE
Phone: 334-727-0550