Healthcare Provider Details

I. General information

NPI: 1255356416
Provider Name (Legal Business Name): US ARMY NURSING CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/12/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

WEED ARMY COMMUNITY HOSPITAL
FORT IRWIN CA
92310-5109
US

IV. Provider business mailing address

684 IDLEWOOD BLVD
BALDWINSVILLE NY
13027-3042
US

V. Phone/Fax

Practice location:
  • Phone: 760-386-2800
  • Fax:
Mailing address:
  • Phone: 315-638-3444
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code275N00000X
TaxonomyMedicare Defined Swing Bed Hospital Unit
License Number533699
License Number StateNY

VIII. Authorized Official

Name: MICHAEL A DOOLITTLE
Title or Position: STAFF NURSE
Credential: RN
Phone: 760-386-2800