Healthcare Provider Details

I. General information

NPI: 1447664727
Provider Name (Legal Business Name): ACH BAYNE-JONES-FT JOHNSON
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/16/2014
Last Update Date: 07/28/2025
Certification Date: 07/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1585 3RD ST BLDG 285 BAYNE JONES ARMY COMMUNITY HOSPITAL
FORT POLK LA
71459-5102
US

IV. Provider business mailing address

BAYNE JONES ARMY COMMUNITY HOSPITAL 1585 3RD STREE BUILDING 285
FORT POLK LA
71459-5102
US

V. Phone/Fax

Practice location:
  • Phone: 337-531-8090
  • Fax: 337-531-3614
Mailing address:
  • Phone: 337-531-8090
  • Fax: 337-531-3614

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332000000X
TaxonomyMilitary/U.S. Coast Guard Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: HECTOR MORALES
Title or Position: DHA POD
Credential:
Phone: 210-536-6118