1285724500 NPI number — USAMEDDAC WURZBURG UNIT 26610

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 1285724500 NPI number — USAMEDDAC WURZBURG UNIT 26610

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
USAMEDDAC WURZBURG UNIT 26610
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:
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:
1285724500
Entity Type Code:
Organization
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:
USAMEDDAC WURZBURG HEALTH CLINIC
Provider Second Line Business Mailing Address:
UNIT 26610
Provider Business Mailing Address City Name:
APO
Provider Business Mailing Address State Name:
AE
Provider Business Mailing Address Postal Code:
09244
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
011499318043626
Provider Business Mailing Address Fax Number:
011499318043241

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
USAMEDDAC WURZBURG HEALTH CLINIC
Provider Second Line Business Practice Location Address:
UNIT 26610
Provider Business Practice Location Address City Name:
APO
Provider Business Practice Location Address State Name:
AE
Provider Business Practice Location Address Postal Code:
09244
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
011499318043626
Provider Business Practice Location Address Fax Number:
011499318043241
Provider Enumeration Date:
10/16/2006

Additional Information

Authorized Official

Authorized Official Last Name:
SWAFFORD
Authorized Official First Name:
PIERRE
Authorized Official Middle Name:
Authorized Official Title or Position:
CREDENTIALING SPECIALIST
Authorized Official Telephone Number:
011499318043626

Provider Taxonomy Codes

  • Taxonomy code: 163WC0400X , with the licence number:  R862913 , registered in the state of MS ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





Copyright © 2007-2025 www.npivalidator.com