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General NPI Number Information
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NPI Number | 1710238985
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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 | 09/27/2012
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Last Update Date | 09/27/2012
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Provider Practice Location Address
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Address Line | 2907 PLEASANT VALLEY BLVD
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City | ALTOONA
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State | PA
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Zip | 16602-4305
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Country | US
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Telephone | 814-943-8161
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Fax |
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Provider Business Mailing Address
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Address Line | 2907 PLEASANT VALLEY BLVD
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City | ALTOONA
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State | PA
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Zip | 16602-4305
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Country | US
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Telephone | 814-943-8161
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Fax |
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Authorized Official
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Title or Position | CREDENTIALING COORDINATOR
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Name | VERA GEHRINGER
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Credential |
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Telephone | 814-943-8164
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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 | OA002903
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 286500000X
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Taxonomy Name | Military Hospital
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License Number | MA055612
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License Number State | PA
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