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General NPI Number Information
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NPI Number | 1366427643
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Entity Type | Organization
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Legal Business Name | DEWITT ARMY COMMUNITY HOSPITAL
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Dates
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Enumeration Date | 12/09/2005
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 9501 FARRELL RD
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City | FORT BELVOIR
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State | VA
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Zip | 22060-5901
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Country | US
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Telephone | 703-805-0599
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Fax |
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Provider Business Mailing Address
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Address Line | 9926 GARDENIA LN
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City | MANASSAS
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State | VA
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Zip | 20109-5413
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Country | US
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Telephone | 703-335-5065
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Fax |
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Authorized Official
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Title or Position | LICENSED PRACTICAL NURSE
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Name | MRS. SHANTELL L. ALLISON
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Credential |
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Telephone | 703-805-0169
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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 | 0002063555
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License Number State | VA
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