Healthcare Provider Details

I. General information

NPI: 1144269564
Provider Name (Legal Business Name): NH OKINAWA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/05/2006
Last Update Date: 06/13/2025
Certification Date: 06/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PSC 482
FPO AP
96362-0017
US

IV. Provider business mailing address

PSC 482 BOX 1600
FPO AP
96362-0017
US

V. Phone/Fax

Practice location:
  • Phone: 251-292-2775
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2865M2000X
TaxonomyMilitary General Acute Care Hospital
License Number
License Number State

VIII. Authorized Official

Name: SUSAN DE LOS RIOS
Title or Position: UBO MANAGER
Credential:
Phone: 251-292-2775