| NPI | 1245210384 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SERENA LYNN HANSKEN Air Force Uniform Business Office 703-588-6419 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1100X Clinic/Center, MilitaryU.S. Coast Guard Outpatient |
| Additional Taxonomies | 261QM1101X Clinic/Center, Military and U.S. Coast Guard Ambulatory Procedure |
| 332000000X MilitaryU.S. Coast Guard Pharmacy | |
| Enumeration Date | 2006-01-17 |
| Last Update Date | 2010-11-15 |