Healthcare Provider Details
I. General information
NPI: 1265590756
Provider Name (Legal Business Name): US ARMY- WOMACK ARMY MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/05/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
WOMACK ARMY MEDICAL CTR STOP A, 2817 REILLY ROAD
FORT BRAGG NC
28310-0001
US
IV. Provider business mailing address
3549 ROSEBANK DR
FAYETTEVILLE NC
28311-1134
US
V. Phone/Fax
- Phone: 9
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 286500000X |
| Taxonomy | Military Hospital |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
RICHARD
KYNION
Title or Position: DEPARTMENT CHIEF
Credential:
Phone: 910-907-8458