MEDICARE: U.S. NAVY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QM1102X	Military Outpatient Operational (Transportable) Component Clinic/Center

General Provider Information

NPI Number	:	1659566933
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	U.S. NAVY

Provider Business Mailing Address
First Line	:	3RD MED BN, 3RD MLG
Second Line	:	HANSEN CLINIC, UNIT 38448
City	:	OKINAWA
State	:	FPO
Zip	:	AP
Country	:	JP
Telephone Number	:	011947234960
Fax Number	:

Provider Business Practice Location Address
First Line	:	3RD MED BN, 3RD MLG
Second Line	:	HANSEN CLINIC, UNIT 38448
City	:	OKINAWA
State	:	FPO
Zip	:	AP
Country	:	JP
Telephone Number	:	011947234960
Fax Number	:

Authorized Official
Title or Position	:	INDEPENDENT DUTY CORPSMAN
Name	:	MR. MICHAEL ALBERT ARROYO JR.
Credential	:
Telephone Number	:	7234960

Provider Enumeration Date	:	09/11/2007
Last Update Date	:	08/17/2022

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