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General NPI Number Information
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NPI Number | 1306919501
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Entity Type | Organization
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Legal Business Name | WEED ARMY COMMUNITY HOSPITAL
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Dates
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Enumeration Date | 11/16/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | INNER LOOP
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City | FORT IRWIN
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State | CA
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Zip | 92310-5109
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Country | US
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Telephone | 760-380-5183
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Fax |
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Provider Business Mailing Address
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Address Line | 26591 CUMBERLAND LANE PO BOX 3626
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City | HELANDALE
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State | CA
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Zip | 92342
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Country | US
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Telephone | 760-243-3276
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Fax |
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Authorized Official
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Title or Position | RN
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Name | MRS. BRENDA JEANNETTE STOCKHILL
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Credential |
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Telephone | 760-380-5183
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2865M2000X
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Taxonomy Name | Military General Acute Care Hospital
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License Number | RN2117372
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License Number State | FL
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