Organization
VA MEDICAL CENTER, PHILADELPHIA PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL J SULLIVAN (DIRECTOR)
(215) 823-5857
Entity
Organization
Contact information
Practice address
3900 WOODLAND AVENUE, PATHOLOGY & LAB. MED. (113) - VAMC CLIN. ADD. BLDG., PHILADELPHIA, PA 19104-4551
(215) 823-5182
(215) 823-4271
Mailing address
715 N. ITHAN AVENUE, ROSEMONT, PA 19010-1729
(215) 823-5182
(215) 823-4271
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
MD-036835L
PA
Other
Enumeration date
10/04/2006
Last updated
08/22/2020
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