Organization · Type 2 NPI
St. Louis JC Vamc
VA Clinic/Center · Harrisburg, IL
NPI number
1497012652
Active
Practice location
608 Rollie Moore Drive
Harrisburg, IL 62946-9998
Mailing address
PO Box 94462
Cleveland, OH 44101-4462
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| VA Clinic/Center Primary | 261QV0200X | None listed |
VA Clinic/Center: Definition to come...
About NPI 1497012652
St. Louis JC Vamc's National Provider Identifier is 1497012652, issued on Apr 12, 2012. The primary taxonomy on file is VA Clinic/Center (261QV0200X), and the practice location is in Harrisburg, IL. The record was last updated on Jan 17, 2018.