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General NPI Number Information
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NPI Number | 1427262518
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Entity Type | Organization
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Legal Business Name | US ARMY HEALTH CLINIC
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Dates
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Enumeration Date | 05/09/2007
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Last Update Date | 11/17/2015
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Provider Practice Location Address
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Address Line | TOOELE ARMY DEPOT BLDG 400
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City | TOOELE
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State | UT
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Zip | 84074
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Country | US
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Telephone | 435-831-3311
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Fax |
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Provider Business Mailing Address
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Address Line | 5116 KISTER AVE ATTN MSA OFFICE
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City | DUGWAY
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State | UT
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Zip | 84022-1097
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Country | US
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Telephone | 435-831-3313
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Fax |
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Authorized Official
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Title or Position | UBO MANAGER
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Name | ELIZABETH BURLINGAME
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Credential |
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Telephone | 719-526-7291
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1100X
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Taxonomy Name | Military/U.S. Coast Guard Outpatient Clinic/Center
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License Number |
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License Number State |
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