Provider Demographics
NPI:1295178796
Name:VA MEDICAL CENTER
Entity Type:Organization
Organization Name:VA MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOCIAL WORK CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:
Authorized Official - Last Name:STEVENSON
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:401-273-7100
Mailing Address - Street 1:16 CHARLES ST
Mailing Address - Street 2:3RD FLOOR
Mailing Address - City:LINCOLN
Mailing Address - State:RI
Mailing Address - Zip Code:02865-1906
Mailing Address - Country:US
Mailing Address - Phone:401-301-0076
Mailing Address - Fax:
Practice Address - Street 1:16 CHARLES ST
Practice Address - Street 2:3RD FLOOR
Practice Address - City:LINCOLN
Practice Address - State:RI
Practice Address - Zip Code:02865-1906
Practice Address - Country:US
Practice Address - Phone:401-301-0076
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-15
Last Update Date:2013-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RICSW01547286500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes286500000XHospitalsMilitary Hospital