Organization
VA MEDICAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHEILA E JORDAN R.R.T. (SUPVR. CARDIOPULMONARY SVC)
(740) 773-1141
Entity
Organization
Contact information
Practice address
17273 STATE ROUTE 104, CHILLICOTHE, OH 45601-9718
(740) 773-1141
Mailing address
17273 STATE ROUTE 104, CHILLICOTHE, OH 45601-9718
(740) 773-1141
Taxonomy
Speciality
Code
Description
License number
State
2865M2000X
Military General Acute Care Hospital
Primary
4755
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4755
OHIO RESPIRATORY CARE LICENSE NUMBER
OH
Enumeration date
07/02/2009
Last updated
07/02/2009
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