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NPI Code Detail

MEDICARE: REYNOLDS ARMY COMMUNITY HOSPITAL

MEDICARE: REYNOLDS ARMY COMMUNITY HOSPITAL
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
1261QM1100XMilitary/U.S. Coast Guard Outpatient Clinic/Center

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11487752960OTHERPARENT NPI

General Provider Information

NPI Number : 1912377649
Entity Type Code : Organization
Provider Name (Legal Business Name) : REYNOLDS ARMY COMMUNITY HOSPITAL
Provider Business Mailing Address
First Line : 3009 N.W. WILSON ROAD
Second Line : ATTN MCUA-PAD-PF
City : FT SILL
State : OK
Zip : 73503-9042
Country : US
Telephone Number : 580-458-2793
Fax Number :
Provider Business Practice Location Address
First Line : 3161 HOSKINS RD
Second Line :
City : FORT SILL
State : OK
Zip : 73503-4462
Country : US
Telephone Number : 580-558-2800
Fax Number :
Authorized Official
Title or Position : UBO MANAGER
Name : IRMIN TROUCHE
Credential :
Telephone Number : 580-558-8435
Provider Enumeration Date : 10/07/2015
Last Update Date : 10/07/2015

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Directions to “REYNOLDS ARMY COMMUNITY HOSPITAL ” Practice Location

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