# VA CENTER

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1790083475
- **Authorized official:** MRS. KIMBERLY MCDIFFITT CPMSM,CPCS (MEDICAL STAFF DIRECTOR)
- **Authorized official phone:** (304) 263-0811

## Contact information

- **Practice address:** 510 BUTLER AVE, MARTINSBURG, WV 25405-9990
- **Practice address phone:** (304) 263-0811
- **Mailing address:** PO BOX 501, KEARNEYSVILLE, WV 25430-0501
- **Mailing address phone:** (304) 876-3529

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 286500000X | Military Hospital | 59640 | WV | Yes |

## Other

- **Enumeration date:** 03/04/2011
- **Last updated:** 03/04/2011