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NPI Code Detail

MEDICARE: FORT BELVOIR COMMUNITY HOSPITAL

MEDICARE: FORT BELVOIR COMMUNITY HOSPITAL
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
1261QM1100XMilitary/U.S. Coast Guard Outpatient Clinic/Center

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11134294705OTHERPARENT FACILITY NPI

General Provider Information

NPI Number : 1376758193
Entity Type Code : Organization
Provider Name (Legal Business Name) : FORT BELVOIR COMMUNITY HOSPITAL
Provider Business Mailing Address
First Line : 9300 DEWITT LOOP
Second Line : ATTN TPCP
City : FORT BELVOIR
State : VA
Zip : 22060-5901
Country : US
Telephone Number : 571-231-2856
Fax Number :
Provider Business Practice Location Address
First Line : 10580 ARROWHEAD DR
Second Line :
City : FAIRFAX
State : VA
Zip : 22030-7301
Country : US
Telephone Number : 571-432-2600
Fax Number :
Authorized Official
Title or Position : UBO MANAGER
Name : OSCAR HARTLEY
Credential :
Telephone Number : 571-231-2866
Provider Enumeration Date : 05/14/2007
Last Update Date : 12/20/2012

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Directions to “FORT BELVOIR COMMUNITY HOSPITAL ” Practice Location

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