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General NPI Number Information
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NPI Number | 1609806504
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Entity Type | Organization
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Legal Business Name | VA MEDICAL CENTER
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Dates
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Enumeration Date | 07/04/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 940 CAPELLA CREEK WAY
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City | GRAYSON
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State | GA
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Zip | 30017-1578
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Country | US
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Telephone | 770-972-3658
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Fax |
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Provider Business Mailing Address
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Address Line | 940 CAPELLA CREEK WAY
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City | GRAYSON
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State | GA
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Zip | 30017-1578
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Country | US
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Telephone | 770-972-3658
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Fax |
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Authorized Official
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Title or Position | NURSE MANAGER
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Name | MRS. VICKY DARLENE CAMPBELL-HEMMING
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Credential | RN
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Telephone | 404-321-6111
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 286500000X
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Taxonomy Name | Military Hospital
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License Number |
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License Number State | GA
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