Healthcare Provider Details

I. General information

NPI: 1043385891
Provider Name (Legal Business Name): ERMC UNIFORM BUSINESS OFFICE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/21/2006
Last Update Date: 01/22/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

UNIT 21420 BOX 3530
APO AE
09705
US

IV. Provider business mailing address

CMR 402 BLDG 3700 ERMC UBO
APO AE
09180
US

V. Phone/Fax

Practice location:
  • Phone: 011496371865214
  • Fax:
Mailing address:
  • Phone: 01149637194647400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM1100X
TaxonomyMilitary/U.S. Coast Guard Outpatient Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332000000X
TaxonomyMilitary/U.S. Coast Guard Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: HELEN SNYDER
Title or Position: HEALTH SYSTEMS SPEC
Credential:
Phone: 01149637194645471