| NPI | 1558907873 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBRA FITZGERALD Health Syst EMS Specialist 757-628-4363 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1100X Clinic/Center, MilitaryU.S. Coast Guard Outpatient |
| Enumeration Date | 2019-11-21 |
| Last Update Date | 2019-11-21 |