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General NPI Number Information
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NPI Number | 1093968166
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Entity Type | Organization
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Legal Business Name | VA HEALTHCARE SYSTEM
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Dates
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Enumeration Date | 11/03/2008
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Last Update Date | 11/03/2008
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Provider Practice Location Address
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Address Line | 10000 BAY PINES BLVD
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City | BAY PINES
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State | FL
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Zip | 33744
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Country | US
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Telephone | 727-398-6661
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Fax |
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Provider Business Mailing Address
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Address Line | 2979 HEATHER TRL
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City | CLEARWATER
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State | FL
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Zip | 33761-3313
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Country | US
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Telephone | 727-793-9166
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Fax |
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Authorized Official
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Title or Position | CHIEF OF STAFF
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Name | DR. GEORGE F. VAN BUSKIRK
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Credential | M.D.
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Telephone | 727-398-6661
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number | ME 21505
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License Number State | FL
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