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General NPI Number Information
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NPI Number | 1447341771
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Entity Type | Organization
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Legal Business Name | DORN VAMC
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Dates
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Enumeration Date | 09/28/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 241 LOST BRANCH RD
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City | LEXINGTON
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State | SC
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Zip | 29072-9023
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Country | US
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Telephone | 803-359-7184
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Fax |
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Provider Business Mailing Address
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Address Line | 241 LOST BRANCH RD
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City | LEXINGTON
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State | SC
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Zip | 29072-9023
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Country | US
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Telephone | 803-359-7184
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Fax |
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Authorized Official
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Title or Position | STAFF
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Name | CATHY ANNE WEBSTER
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Credential |
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Telephone | 803-776-4000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number | 11464
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License Number State | SC
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