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General NPI Number Information
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NPI Number | 1245312792
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Entity Type | Organization
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Legal Business Name | HOHENFELS ARMY HEALTH CLINIC
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Dates
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Enumeration Date | 10/20/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 9 CITADEL ST
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City | PIEDMONT
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State | SC
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Zip | 29673
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Country | US
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Telephone | 864-299-1223
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Fax |
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Provider Business Mailing Address
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Address Line | CMR 414 BOX 1878
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City | APO
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State | AE
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Zip | 09173
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Country | DE
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Telephone | 01149497949454
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Fax |
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Authorized Official
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Title or Position | EFMP / DIABETIC COORDINATOR/ NURSE
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Name | MRS. LATONYA R. ADAMS
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Credential | LPN
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Telephone | -466-4583
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | 23-34115-122
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License Number State | KS
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