1912313222 NPI number — IRELAND ARMY COMMUNITY HOSPITAL

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1912313222 NPI number — IRELAND ARMY COMMUNITY HOSPITAL

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
IRELAND ARMY COMMUNITY HOSPITAL
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:
Provider Other Organization Name Type Code:
6
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:
1912313222
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/19/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
IRELAND ARMY COMMUNITY HOSPITAL
Provider Second Line Business Mailing Address:
TREASURERS OFFICE 289 IRELAND AVE
Provider Business Mailing Address City Name:
FORT KNOX
Provider Business Mailing Address State Name:
KY
Provider Business Mailing Address Postal Code:
40121-5111
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
309-782-0550
Provider Business Mailing Address Fax Number:
309-782-0553

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
BLDG 110 RODMAN AVE.
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ROCK ISLAND ARSENAL
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
61299-7240
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
309-782-0550
Provider Business Practice Location Address Fax Number:
309-782-0553
Provider Enumeration Date:
07/08/2014

Additional Information

Authorized Official

Authorized Official Last Name:
MORALES
Authorized Official First Name:
HECTOR
Authorized Official Middle Name:
Authorized Official Title or Position:
CHIEF DHA PASS
Authorized Official Telephone Number:
210-536-6650

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: 2146682 . This is a "PK" identifier . This identifiers is of the category "OTHER".




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