Organization
BAY PINES VA MEDICAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PAUL V LARCKA (ACTING CHIEF PHARMACIST)
(727) 398-6661
Entity
Organization
Contact information
Practice address
1920 MASON AVE, DAYTONA BEACH, FL 32117-5103
(386) 274-3460
(386) 274-3487
Mailing address
712 DERBYSHIRE RD, DAYTONA BEACH, FL 32114-1606
(386) 274-3460
(386) 274-3487
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Enumeration date
07/12/2008
Last updated
07/12/2008
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