Provider Demographics
NPI:1770528309
Name:DEPT. OF VETERANS AFFAIRS
Entity type:Organization
Organization Name:DEPT. OF VETERANS AFFAIRS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LPN
Authorized Official - Prefix:MS
Authorized Official - First Name:GLORIA
Authorized Official - Middle Name:A
Authorized Official - Last Name:MILLIGAN
Authorized Official - Suffix:
Authorized Official - Credentials:NURSING
Authorized Official - Phone:404-728-7614
Mailing Address - Street 1:1449 STONE MILL TRCE
Mailing Address - Street 2:
Mailing Address - City:STONE MTN
Mailing Address - State:GA
Mailing Address - Zip Code:30083-1526
Mailing Address - Country:US
Mailing Address - Phone:404-434-3642
Mailing Address - Fax:
Practice Address - Street 1:1449 STONE MILL TRCE
Practice Address - Street 2:
Practice Address - City:STONE MTN
Practice Address - State:GA
Practice Address - Zip Code:30083-1526
Practice Address - Country:US
Practice Address - Phone:404-434-3642
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-18
Last Update Date:2008-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2-0245702865M2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2865M2000XHospitalsMilitary HospitalMilitary General Acute Care Hospital