| NPI | 1194730846 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KERTREDIA DAVIS Ubo Manager 762-408-0007 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2865M2000X Military Hospital, Military General Acute Care Hospital |
| Additional Taxonomies | 261QM1100X Clinic/Center, MilitaryU.S. Coast Guard Outpatient |
| 261QM1101X Clinic/Center, Military and U.S. Coast Guard Ambulatory Procedure | |
| Enumeration Date | 2006-07-30 |
| Last Update Date | 2020-10-05 |