Provider Demographics
NPI:1528239621
Name:VETERANS ADMINISTRATION MEDICAL CENTER
Entity type:Organization
Organization Name:VETERANS ADMINISTRATION MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL AFFAIRS OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:
Authorized Official - Last Name:BURROWS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:401-273-7100
Mailing Address - Street 1:50 STEUBEN ST
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02909-3112
Mailing Address - Country:US
Mailing Address - Phone:850-294-0223
Mailing Address - Fax:
Practice Address - Street 1:2 HEATHMAN ROAD
Practice Address - Street 2:WHITE HALL, RM 309
Practice Address - City:KINGSTON
Practice Address - State:RI
Practice Address - Zip Code:02881
Practice Address - Country:US
Practice Address - Phone:401-874-5342
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-17
Last Update Date:2008-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIRN 38958273R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273R00000XHospital UnitsPsychiatric Unit