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General NPI Number Information
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NPI Number | 1790791143
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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 | 07/31/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 830 CHALKSTONE AVE
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City | PROVIDENCE
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State | RI
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Zip | 02908-4734
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Country | US
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Telephone | 401-273-7100
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Fax |
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Provider Business Mailing Address
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Address Line | 3046 RIVERSIDE AVE
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City | SOMERSET
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State | MA
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Zip | 02726-5322
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Country | US
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Telephone | 508-673-3002
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Fax |
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Authorized Official
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Title or Position | LPN
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Name | MRS. EILEEN M CHMIELEWSKI
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Credential | LPN
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Telephone | 401-273-7100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2865M2000X
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Taxonomy Name | Military General Acute Care Hospital
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License Number | LPN08256
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License Number State | RI
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