Provider Demographics
NPI:1821350497
Name:DEPARTMENT OF VETERANS AFFAIRS MEDS BY MAIL
Entity Type:Organization
Organization Name:DEPARTMENT OF VETERANS AFFAIRS MEDS BY MAIL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EBILLING PROJECT MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:
Authorized Official - Last Name:DUNCAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:202-382-2579
Mailing Address - Street 1:2103 VETERANS BLVD
Mailing Address - Street 2:UNIT 2
Mailing Address - City:DUBLIN
Mailing Address - State:GA
Mailing Address - Zip Code:31021-7502
Mailing Address - Country:US
Mailing Address - Phone:478-274-5534
Mailing Address - Fax:478-274-5536
Practice Address - Street 1:2103 VETERANS BLVD
Practice Address - Street 2:UNIT 2
Practice Address - City:DUBLIN
Practice Address - State:GA
Practice Address - Zip Code:31021-7502
Practice Address - Country:US
Practice Address - Phone:478-274-5534
Practice Address - Fax:478-274-5536
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-11
Last Update Date:2013-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332100000XSuppliersDepartment of Veterans Affairs (VA) Pharmacy