Healthcare Provider Details

I. General information

NPI: 1306162359
Provider Name (Legal Business Name): DEPARTMENT OF VETERAN AFFAIRS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/15/2010
Last Update Date: 04/15/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6110 PLUMAS ST
RENO NV
89519-6076
US

IV. Provider business mailing address

6110 PLUMAS ST
RENO NV
89519-6076
US

V. Phone/Fax

Practice location:
  • Phone: 775-328-1490
  • Fax:
Mailing address:
  • Phone: 775-328-1490
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code286500000X
TaxonomyMilitary Hospital
License Number5237-C
License Number StateNV

VIII. Authorized Official

Name: ELIZABETH BARAJAS
Title or Position: LEAD FINANCIAL ACCOUNT TECHNICIAN
Credential:
Phone: 775-328-1490