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General NPI Number Information
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NPI Number | 1851698005
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Entity Type | Organization
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Legal Business Name | BOSTON VA HEALTHCARE SYSTEM
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Dates
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Enumeration Date | 02/24/2011
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Last Update Date | 02/24/2011
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Provider Practice Location Address
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Address Line | 1400 VFW PKWY
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City | WEST ROXBURY
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State | MA
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Zip | 02132-4927
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Country | US
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Telephone | 617-323-1100
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Fax |
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Provider Business Mailing Address
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Address Line | 1400 VFW PKWY
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City | WEST ROXBURY
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State | MA
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Zip | 02132-4927
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Country | US
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Telephone | 617-323-1100
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Fax |
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Authorized Official
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Title or Position | CHIEF OF FOOD AND NUTRITION SERVICE
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Name | SUSAN HARTERY
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Credential | RD
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Telephone | 774-826-1919
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number | 000003116
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License Number State | MA
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