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General NPI Number Information
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NPI Number | 1720292501
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Entity Type | Organization
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Legal Business Name | ALEXANDER T AUGUSTA MED CTR-FT BELVOIR
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Dates
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Enumeration Date | 05/10/2007
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Last Update Date | 05/30/2025
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Provider Practice Location Address
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Address Line | THE PENTAGON
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City | WASHINGTON
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State | DC
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Zip | 20310-5600
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Country | US
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Telephone | 301-295-4934
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Fax |
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Provider Business Mailing Address
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Address Line | 8901 WISCONSIN AVE PSC BOX 509 CODE 6300
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City | BETHESDA
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State | MD
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Zip | 20889-5600
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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 | DHA UBO
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Name | WILLIAM MICHAEL CONDON
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Credential |
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Telephone | 240-401-3643
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332000000X
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Taxonomy Name | Military/U.S. Coast Guard Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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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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