Provider Demographics
NPI:1710148986
Name:BUTLER VA MEDICAL CENTER
Entity Type:Organization
Organization Name:BUTLER VA MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RN
Authorized Official - Prefix:
Authorized Official - First Name:ARLEEN
Authorized Official - Middle Name:P
Authorized Official - Last Name:CRISCI
Authorized Official - Suffix:
Authorized Official - Credentials:BSN
Authorized Official - Phone:724-598-0236
Mailing Address - Street 1:341 LAUREL BLVD
Mailing Address - Street 2:
Mailing Address - City:NEW CASTLE
Mailing Address - State:PA
Mailing Address - Zip Code:16101-0407
Mailing Address - Country:US
Mailing Address - Phone:724-658-9492
Mailing Address - Fax:
Practice Address - Street 1:341 LAUREL BLVD
Practice Address - Street 2:
Practice Address - City:NEW CASTLE
Practice Address - State:PA
Practice Address - Zip Code:16101-0407
Practice Address - Country:US
Practice Address - Phone:724-658-9492
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-20
Last Update Date:2008-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0210041104Medicaid