1902840564 NPI number — MR. GARRY VERN BEST U.S. NAVY IDC

Table of content: MR. GARRY VERN BEST U.S. NAVY IDC (NPI 1902840564)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1902840564 NPI number — MR. GARRY VERN BEST U.S. NAVY IDC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BEST
Provider First Name:
GARRY
Provider Middle Name:
VERN
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
Provider Credential Text:
U.S. NAVY IDC
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
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:
1902840564
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/21/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4058 GRAYBACK DR
Provider Second Line Business Mailing Address:
U12
Provider Business Mailing Address City Name:
SILVERDALE
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
98315-9649
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
360-535-7170
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
USS OHIO (SSGN 726)
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FPO
Provider Business Practice Location Address State Name:
AP
Provider Business Practice Location Address Postal Code:
96698-2093
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
360-476-8351
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/15/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1710I1002X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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