Healthcare Provider Details

I. General information

NPI: 1437236817
Provider Name (Legal Business Name): AHC BG CRAWFORD F SAMS-CAMP ZAMA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/01/2006
Last Update Date: 05/22/2025
Certification Date: 05/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

UNIT 45011 JAPAN
APO AP
96338-5011
US

IV. Provider business mailing address

MSA OFFICE ATTN MCJA-PA
APO AP
96343-5011
US

V. Phone/Fax

Practice location:
  • Phone: 01181464074127
  • Fax:
Mailing address:
  • Phone: 01181464074693
  • 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

VIII. Authorized Official

Name: AILEEN AGUILAR
Title or Position: UBO MANAGER
Credential:
Phone: 11-810-4640