Provider Demographics
NPI:1679768568
Name:TOGUS VA MEDICAL CENTER
Entity Type:Organization
Organization Name:TOGUS VA MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL STAFF COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:CHERI
Authorized Official - Middle Name:L
Authorized Official - Last Name:NICHLOSI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-623-8411
Mailing Address - Street 1:1 VA CENTER
Mailing Address - Street 2:TOGUS VETERNS AFFAIRS MEDICAL CENTER
Mailing Address - City:AUGUSTA
Mailing Address - State:ME
Mailing Address - Zip Code:04330
Mailing Address - Country:US
Mailing Address - Phone:207-623-8411
Mailing Address - Fax:207-623-5702
Practice Address - Street 1:1 VA CENTER
Practice Address - Street 2:DEPARTMENT OF VETERANS AFFAIRS
Practice Address - City:AUGUSTA
Practice Address - State:ME
Practice Address - Zip Code:04330
Practice Address - Country:US
Practice Address - Phone:207-623-8411
Practice Address - Fax:207-623-5702
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-13
Last Update Date:2007-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MELC10658286500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes286500000XHospitalsMilitary Hospital