Provider Demographics
NPI:1770651069
Name:VETERAN HOSPITAL
Entity Type:Organization
Organization Name:VETERAN HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RN-BSN CHARGE NURSE 12-8
Authorized Official - Prefix:MRS
Authorized Official - First Name:WANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:RUBIO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-384-7711
Mailing Address - Street 1:340 SUGARTOWN RD APT C84
Mailing Address - Street 2:
Mailing Address - City:DEVON
Mailing Address - State:PA
Mailing Address - Zip Code:19333-2310
Mailing Address - Country:US
Mailing Address - Phone:610-308-2052
Mailing Address - Fax:
Practice Address - Street 1:340 SUGARTOWN RD APT C84
Practice Address - Street 2:
Practice Address - City:DEVON
Practice Address - State:PA
Practice Address - Zip Code:19333-2310
Practice Address - Country:US
Practice Address - Phone:610-308-2052
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR25338315D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes315D00000XNursing & Custodial Care FacilitiesHospice, Inpatient