Organization
VETERANS ADMINISTRATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHELLA STOVALL (DIRECTOR OF NURSING)
(801) 582-1565
Entity
Organization
Contact information
Practice address
1901 BERKELEY ST., SALT LAKE CITY, UT 84108
(801) 582-1565
(801) 584-2576
Mailing address
1901 BERKELEY ST, SALT LAKE CITY, UT 84108-3201
(801) 582-1565
(801) 582-1565
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
213999-3102
UT
Other
Enumeration date
05/22/2012
Last updated
05/22/2012
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