Provider Demographics
NPI:1679812275
Name:HUNTER HOLMES MCGUIRE VETERAN ADMINISTRATION MEDICAL CENTER
Entity type:Organization
Organization Name:HUNTER HOLMES MCGUIRE VETERAN ADMINISTRATION MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOCIAL WORKER
Authorized Official - Prefix:MS
Authorized Official - First Name:CHARLENE
Authorized Official - Middle Name:J
Authorized Official - Last Name:CHRISTIAN
Authorized Official - Suffix:
Authorized Official - Credentials:LSW
Authorized Official - Phone:804-675-5000
Mailing Address - Street 1:1201 BROAD ROCK BLVD
Mailing Address - Street 2:SOCIAL WORK SERVICES-#122
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23249-0001
Mailing Address - Country:US
Mailing Address - Phone:804-675-5000
Mailing Address - Fax:804-675-5293
Practice Address - Street 1:1201 BROAD ROCK BLVD
Practice Address - Street 2:SOCIAL WORK SERVICES-#122
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23249-0001
Practice Address - Country:US
Practice Address - Phone:804-675-5000
Practice Address - Fax:804-675-5293
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-04
Last Update Date:2013-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0903001710286500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes286500000XHospitalsMilitary Hospital