1912061664 NPI number — BG CRAWFORD F SAMS ARMY HEALTH CLINIC

Table of content: (NPI 1912061664)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1912061664 NPI number — BG CRAWFORD F SAMS ARMY HEALTH CLINIC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BG CRAWFORD F SAMS ARMY HEALTH CLINIC
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:
CAMP ZAMA OTC PHCY
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:
1912061664
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/25/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
MSA OFFICE
Provider Second Line Business Mailing Address:
ATTN MCJA-PA
Provider Business Mailing Address City Name:
APO
Provider Business Mailing Address State Name:
AP
Provider Business Mailing Address Postal Code:
96343-5011
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
01181464074693
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
UNIT 45011
Provider Second Line Business Practice Location Address:
CAMP ZAMA OTC PHCY
Provider Business Practice Location Address City Name:
APO
Provider Business Practice Location Address State Name:
AP
Provider Business Practice Location Address Postal Code:
96338-5011
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
01181464074475
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/20/2006

Additional Information

Authorized Official

Authorized Official Last Name:
MORALES
Authorized Official First Name:
HECTOR
Authorized Official Middle Name:
Authorized Official Title or Position:
PHARMACY OPERATIONS CENTER MGR
Authorized Official Telephone Number:
210-221-8443

Provider Taxonomy Codes

  • Taxonomy code: 332000000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 8210382 . This is a "NCPDP" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1437236817 . This is a "PARENT FACILITY BG CRAWFORD F SAMS ARMY HEALTH CLINIC NPI" identifier . This identifiers is of the category "OTHER".




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