| NPI | 1487630356 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THERESA M. MITCHELL Air Force Uniform Business Office 703-681-7613 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1100X Clinic/Center Military/U.S. Coast Guard Outpatient |
| Additional Taxonomies | 261QM1101X Clinic/Center Military and U.S. Coast Guard Ambulatory Procedure |
| 332000000X Military/U.S. Coast Guard Pharmacy | |
| Enumeration Date | 2005-12-21 |
| Last Update Date | 2014-08-08 |