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General NPI Number Information
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NPI Number | 1578007183
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Entity Type | Organization
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Legal Business Name | DEPARTMENT OF VETERANS AFFAIRS
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Dates
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Enumeration Date | 12/16/2016
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Last Update Date | 12/16/2016
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Provider Practice Location Address
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Address Line | 915 W EMMA AVE
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City | COEUR D ALENE
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State | ID
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Zip | 83814-2531
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Country | US
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Telephone | 208-665-1700
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Fax |
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Provider Business Mailing Address
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Address Line | 915 W EMMA AVE
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City | COEUR D ALENE
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State | ID
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Zip | 83814-2531
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Country | US
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Telephone | 208-665-1700
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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 | REBECCA MEIERS
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Credential | D.O
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Telephone | 509-434-7000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QV0200X
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Taxonomy Name | VA Clinic/Center
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License Number |
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License Number State |
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