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General NPI Number Information
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NPI Number | 1942503081
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Entity Type | Organization
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Legal Business Name | US NAVY
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Dates
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Enumeration Date | 12/13/2010
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Last Update Date | 12/13/2010
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Provider Practice Location Address
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Address Line | 3D MLG CLR 37 KGAS UNIT 38404
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City | FPO
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State | AP
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Zip | 96604-8404
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Country | US
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Telephone | 315-637-1250
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Fax |
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Provider Business Mailing Address
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Address Line | 3D MLG CLR37 KGAS UNIT 38404
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City | FPO
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State | AP
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Zip | 96604-8404
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Country | US
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Telephone | 315-637-1250
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Fax |
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Authorized Official
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Title or Position | IDEPENDENT DUTY CORPSMAN
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Name | MR. JASON STUART HARRIS
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Credential | IDC
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Telephone | 315-637-1250
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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 |
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License Number State |
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