Healthcare Provider Details

I. General information

NPI: 1841475324
Provider Name (Legal Business Name): VA MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/03/2008
Last Update Date: 01/03/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1055 CLERMONT ST
DENVER CO
80220-3808
US

IV. Provider business mailing address

1325 S SABLE BLVD
AURORA CO
80012-4632
US

V. Phone/Fax

Practice location:
  • Phone: 303-399-8020
  • Fax: 303-393-5232
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QV0200X
TaxonomyVA Clinic/Center
License Number44683
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code284300000X
TaxonomySpecial Hospital
License Number44683
License Number StateCO

VIII. Authorized Official

Name: MS. LORENE CONNEL
Title or Position: CHEIF, HRMS
Credential:
Phone: 303-399-8020