| NPI | 1124197017 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM JAMES PRIDGEN Ncoic Lpn Waedmaster 760-380-3144 |
| Organization Subpart ? | No |
| Primary Taxonomy | 286500000X Military Hospital (Licence: WA LP00045663) |
| Enumeration Date | 2006-11-07 |
| Last Update Date | 2020-08-22 |