Healthcare Provider Details

I. General information

NPI: 1164686465
Provider Name (Legal Business Name): VA EASTERN KANSAS HEALTH CARE SYSTEM COLMERY-O'NEIL VA MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/16/2008
Last Update Date: 07/16/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2200 SW GAGE BLVD
TOPEKA KS
66622-0001
US

IV. Provider business mailing address

2218 SE 36TH ST
TOPEKA KS
66605-2414
US

V. Phone/Fax

Practice location:
  • Phone: 785-350-3111
  • Fax: 785-350-4496
Mailing address:
  • Phone: 785-350-3111
  • Fax: 785-350-4496

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code286500000X
TaxonomyMilitary Hospital
License Number23-22525-022
License Number StateKS

VIII. Authorized Official

Name: MARIE WELDON
Title or Position: DIRECTOR
Credential: FACHE
Phone: 785-350-3111