Healthcare Provider Details

I. General information

NPI: 1609805241
Provider Name (Legal Business Name): WRAMC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/03/2006
Last Update Date: 04/18/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6900 GEORGIA AVE NW
WASHINGTON DC
20307-0003
US

IV. Provider business mailing address

9300 DEWITT LOOP ATTN FBCH INPT TPCP
FORT BELVOIR VA
22060-5901
US

V. Phone/Fax

Practice location:
  • Phone: 571-231-2856
  • Fax:
Mailing address:
  • Phone: 571-231-2856
  • 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: OSCAR HARTLEY
Title or Position: UBO MANAGER
Credential:
Phone: 571-231-2866