Provider Demographics
NPI:1972568392
Name:W.G. HEFNER VA MEDICAL CENTER
Entity type:Organization
Organization Name:W.G. HEFNER VA MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COTA/L
Authorized Official - Prefix:MS
Authorized Official - First Name:LEANETTA
Authorized Official - Middle Name:GRAY
Authorized Official - Last Name:CHAMBERS
Authorized Official - Suffix:
Authorized Official - Credentials:1778
Authorized Official - Phone:704-638-9000
Mailing Address - Street 1:W.G. HEFNER VA MEDICAL CENTER
Mailing Address - Street 2:1601 BRENNER AVENUE
Mailing Address - City:SALISBURY
Mailing Address - State:NC
Mailing Address - Zip Code:28144-2515
Mailing Address - Country:US
Mailing Address - Phone:704-638-9000
Mailing Address - Fax:704-638-3364
Practice Address - Street 1:1601 BRENNER AVE
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:NC
Practice Address - Zip Code:28144-2515
Practice Address - Country:US
Practice Address - Phone:704-638-9000
Practice Address - Fax:704-638-3364
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-19
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes283X00000XHospitalsRehabilitation Hospital