1881897544 NPI number — NATIONAL NAVAL MEDICAL CENTER

Table of content: (NPI 1881897544)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1881897544 NPI number — NATIONAL NAVAL MEDICAL CENTER

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NATIONAL NAVAL MEDICAL CENTER
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
PENTAGON TRI-SVC DENTAL CLINIC
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1881897544
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/23/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
8901 WISCONSIN AVE
Provider Second Line Business Mailing Address:
PSC BOX 509 CODE 6300
Provider Business Mailing Address City Name:
BETHESDA
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
20889-5600
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
THE PENTAGON
Provider Second Line Business Practice Location Address:
CORRIDOR 8
Provider Business Practice Location Address City Name:
WASHINGTON
Provider Business Practice Location Address State Name:
DC
Provider Business Practice Location Address Postal Code:
20310-0001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
703-692-8700
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/08/2007

Additional Information

Authorized Official

Authorized Official Last Name:
DICKSON
Authorized Official First Name:
MARCIA
Authorized Official Middle Name:
Authorized Official Title or Position:
FINANCIAL MGMT ANALYST
Authorized Official Telephone Number:
301-295-6300

Provider Taxonomy Codes

  • Taxonomy code: 261QM1100X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1639130222 . This is a "PARENT FACILITY NPI EFFECTIVE 1 SEP 2011" identifier . This identifiers is of the category "OTHER".




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