Healthcare Provider Details

I. General information

NPI: 1194004457
Provider Name (Legal Business Name): VA HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/04/2011
Last Update Date: 08/04/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 SPRINGS RD
BEDFORD MA
01730-1114
US

IV. Provider business mailing address

119 SPINNAKER WAY
PORTSMOUTH NH
03801-3369
US

V. Phone/Fax

Practice location:
  • Phone: 781-602-0970
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code286500000X
TaxonomyMilitary Hospital
License Number
License Number State

VIII. Authorized Official

Name: MISS MEGAN KATHERINE MAGUIRE
Title or Position: CLINICAL CASE MANAGER
Credential: LCSW
Phone: 781-602-0970