Healthcare Provider Details

I. General information

NPI: 1528143724
Provider Name (Legal Business Name): WOMACK ARMY MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/26/2006
Last Update Date: 09/25/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2817 REILLY ST
FORT BRAGG NC
28310-7301
US

IV. Provider business mailing address

2817 REILLY RD MCXC-DBO-UB DEPT OF THE ARMY WAMC STOP A
FORT BRAGG NC
28310-7301
US

V. Phone/Fax

Practice location:
  • Phone: 910-907-9262
  • Fax:
Mailing address:
  • Phone: 910-907-8537
  • 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: BARBARA BLACK
Title or Position: UBO MANAGER
Credential:
Phone: 910-907-8537