Provider Demographics
NPI:1255505558
Name:MINNEAPOLIS VETERANS AFFAIR MEDICAL CENTER
Entity Type:Organization
Organization Name:MINNEAPOLIS VETERANS AFFAIR MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PHARMACIST
Authorized Official - Prefix:DR
Authorized Official - First Name:YUSUF
Authorized Official - Middle Name:
Authorized Official - Last Name:DAWOODBHAI
Authorized Official - Suffix:
Authorized Official - Credentials:PHARM D
Authorized Official - Phone:612-467-2040
Mailing Address - Street 1:ONE VETERANS DR
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55417
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:ONE VETERANS DR
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55417
Practice Address - Country:US
Practice Address - Phone:612-467-2040
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-17
Last Update Date:2008-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN118064284300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes284300000XHospitalsSpecial Hospital