| Organization Name: | VA MEDICAL CENTER |
| NPI Number: | 1609883628 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | GERALD ECKENRODE (RESPIRATORY THERAPIST) |
| Mailing Address: | 1111 East End Blvd. Wilkes-barre |
| State: | PA US |
| Postal Code: | 18711 |
| Phone Number: | 5708243521 |
| Fax Number: | |
| NPI Enumeration Date: | 08/02/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 282NC0060X |
| License Number: | YM000449L |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PA |
| Taxonomy Type: | Hospitals |
| Taxonomy Classification: | General Acute Care Hospital |
| Taxonomy Specialization: | Critical Access |
| Taxonomy Definition: | |