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General NPI Number Information
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NPI Number | 1710315981
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Entity Type | Organization
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Legal Business Name | HUNTINGTON VAMC
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Dates
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Enumeration Date | 10/24/2013
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Last Update Date | 10/24/2013
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Provider Practice Location Address
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Address Line | 1540 SPRING VALLEY DR BUILDING 5
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City | HUNTINGTON
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State | WV
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Zip | 25704-9300
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Country | US
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Telephone | 304-429-6741
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Fax |
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Provider Business Mailing Address
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Address Line | 1540 SPRING VALLEY DR BUILDING 5
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City | HUNTINGTON
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State | WV
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Zip | 25704-9300
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Country | US
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Telephone | 304-429-6741
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Fax |
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Authorized Official
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Title or Position | SUPERVISORY SOCIAL WORKER
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Name | MR. JIM MORRIS
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Credential | LICSW
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Telephone | 304-429-0287
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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 | 3566
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License Number State | KY
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