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General NPI Number Information
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NPI Number | 1003985219
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Entity Type | Organization
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Legal Business Name | ACH BRIAN D ALLGOOD-PYEONGTAEK
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Dates
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Enumeration Date | 11/06/2006
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Last Update Date | 06/13/2025
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Provider Practice Location Address
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Address Line | 549TH HOSPITAL CENTER/BDAACH UNIT #15245
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City | APO
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State | AP
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Zip | 96271
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Country | US
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Telephone | 315-737-1857
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Fax |
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Provider Business Mailing Address
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Address Line | 549TH HOSPITAL CENTER/BDAACH UNIT # 15245
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City | APO
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State | AP
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Zip | 96271
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Country | US
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Telephone | 315-737-1857
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Fax |
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Authorized Official
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Title or Position | CHIEF, UBO
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Name | MR. MICHAEL DEWAYNE HENDRICKS
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Credential |
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Telephone | 315-737-1857
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 286500000X
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Taxonomy Name | Military Hospital
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License Number |
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License Number State |
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