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General NPI Number Information
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NPI Number | 1366640039
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Entity Type | Organization
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Legal Business Name | BMC MCAS TORII STATION
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Dates
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Enumeration Date | 07/05/2007
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Last Update Date | 08/07/2008
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Provider Practice Location Address
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Address Line | PSC 482 UNIFORM BUSINESS OFFICE
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City | FPO
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State | AP
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Zip | 96362
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Country | US
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Telephone | 011816117432014
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Fax |
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Provider Business Mailing Address
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Address Line | PSC 482 UNIFORM BUSINESS OFFICE
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City | FPO
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State | AP
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Zip | 96362
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | FISCAL OFFICER
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Name | JEREMY HEATH WESTCOTT
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Credential |
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Telephone | 011816117432021
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1101X
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Taxonomy Name | Military and U.S. Coast Guard Ambulatory Procedure Clinic/Center
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License Number |
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License Number State |
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