MEDICARE: WRAMC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QM1100X	Military/U.S. Coast Guard Outpatient Clinic/Center

General Provider Information

NPI Number	:	1154526812
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WRAMC

Provider Business Mailing Address
First Line	:	9300 DEWITT LOOP
Second Line	:	FBCH OTPT TPCP
City	:	FT BELVOIR
State	:	VA
Zip	:	22060-5285
Country	:	US
Telephone Number	:	571-231-2856
Fax Number	:

Provider Business Practice Location Address
First Line	:	103 3RD AVE SW
Second Line	:
City	:	FORT MCNAIR
State	:	DC
Zip	:	20024-5120
Country	:	US
Telephone Number	:	571-231-2856
Fax Number	:

Authorized Official
Title or Position	:	UBO MANAGER
Name	:	OSCAR HARTLEY
Credential	:
Telephone Number	:	571-231-2866

Provider Enumeration Date	:	06/20/2007
Last Update Date	:	04/18/2014

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Directions to “WRAMC ” Practice Location

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