Basic Information
| Provider Information | |||||||||
| NPI: | 1841475324 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | VA MEDICAL CENTER | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1325 S SABLE BLVD | ||||||||
| Address2: | |||||||||
| City: | AURORA | ||||||||
| State: | CO | ||||||||
| PostalCode: | 800124632 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 1055 CLERMONT ST | ||||||||
| Address2: | |||||||||
| City: | DENVER | ||||||||
| State: | CO | ||||||||
| PostalCode: | 802203808 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3033998020 | ||||||||
| FaxNumber: | 3033935232 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/03/2008 | ||||||||
| LastUpdateDate: | 01/03/2008 | ||||||||
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| AuthorizedOfficialLastName: | CONNEL | ||||||||
| AuthorizedOfficialFirstName: | LORENE | ||||||||
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| AuthorizedOfficialTitleorPosition: | CHEIF, HRMS | ||||||||
| AuthorizedOfficialTelephone: | 3033998020 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MS. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QV0200X | 44683 | CO | N | Ambulatory Health Care Facilities | Clinic/Center | VA | 284300000X | 44683 | CO | Y | Hospitals | Special Hospital |
No ID Information.