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General NPI Number Information
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NPI Number | 1043614654
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Entity Type | Organization
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Legal Business Name | VA MEDICAL CENTER, DAYTON
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Dates
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Enumeration Date | 10/13/2014
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Last Update Date | 10/13/2014
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Provider Practice Location Address
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Address Line | 4100 W 3RD ST
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City | DAYTON
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State | OH
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Zip | 45428-9000
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Country | US
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Telephone | 937-268-6511
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Fax |
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Provider Business Mailing Address
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Address Line | 4100 W 3RD ST
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City | DAYTON
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State | OH
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Zip | 45428-9000
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PHARMACIST
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Name | BRIAN SALZMAN
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Credential |
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Telephone | 937-268-6511
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 281P00000X
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Taxonomy Name | Chronic Disease Hospital
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License Number | 35084010
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License Number State | OH
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