Provider Demographics
NPI:1558674499
Name:US DEPARTMENT OF VETERANS AFFAIRS
Entity Type:Organization
Organization Name:US DEPARTMENT OF VETERANS AFFAIRS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF, NUTRITION & FOOD SERVICES
Authorized Official - Prefix:
Authorized Official - First Name:LUCY
Authorized Official - Middle Name:
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:RD
Authorized Official - Phone:910-822-7038
Mailing Address - Street 1:736 MEDICAL CENTER DR
Mailing Address - Street 2:SUITE 102
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28401-4170
Mailing Address - Country:US
Mailing Address - Phone:910-763-5979
Mailing Address - Fax:
Practice Address - Street 1:736 MEDICAL CENTER DR
Practice Address - Street 2:SUITE 102
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28401-4170
Practice Address - Country:US
Practice Address - Phone:910-763-5979
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-21
Last Update Date:2010-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCL002769286500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes286500000XHospitalsMilitary Hospital