Provider Demographics
NPI:1215032412
Name:VETERAN ADMINISTRATION MEDICAL CENTER
Entity Type:Organization
Organization Name:VETERAN ADMINISTRATION MEDICAL CENTER
Other - Org Name:COATESVILLE MEDICAL CENTER
Other - Org Type:Other Name
Authorized Official - Title/Position:CHEIF OF STAFF
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:F
Authorized Official - Last Name:TISCHLER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:610-384-7711
Mailing Address - Street 1:1400 BLACKHORSE HILL RD
Mailing Address - Street 2:BUILDING 8A-DOM
Mailing Address - City:COATESVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19320-2040
Mailing Address - Country:US
Mailing Address - Phone:610-384-7711
Mailing Address - Fax:610-383-0283
Practice Address - Street 1:28 JOSEPH CT
Practice Address - Street 2:
Practice Address - City:DOWNINGTOWN
Practice Address - State:PA
Practice Address - Zip Code:19335-2264
Practice Address - Country:US
Practice Address - Phone:610-384-7711
Practice Address - Fax:610-383-0283
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-13
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPENDING276400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes276400000XHospital UnitsRehabilitation, Substance Use Disorder Unit