Healthcare Provider Details

I. General information

NPI: 1982084943
Provider Name (Legal Business Name): US COAST GUARD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/04/2015
Last Update Date: 06/04/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2703 MARTIN LUTHER KING JR AVE SE
WASHINGTON DC
20593-0007
US

IV. Provider business mailing address

2703 MARTIN LUTHER KING JR AVE SE
WASHINGTON DC
20593-0007
US

V. Phone/Fax

Practice location:
  • Phone: 202-372-4100
  • Fax:
Mailing address:
  • Phone: 202-372-4100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0002X
TaxonomyClinic Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: JOANNE A WARZYNSKI
Title or Position: CLINIC ADMINISTRATOR
Credential:
Phone: 202-372-4100