1295149383 NPI number — BASSETT ARMY COMMUNITY HOSPITAL

Table of content: (NPI 1295149383)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1295149383 NPI number — BASSETT ARMY COMMUNITY HOSPITAL

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BASSETT 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:
1295149383
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/22/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
BASSETT ARMY COMMUNITY HOSPITAL
Provider Second Line Business Mailing Address:
1060 GAFFNEY RD 7420
Provider Business Mailing Address City Name:
FT WAINWRIGHT
Provider Business Mailing Address State Name:
AK
Provider Business Mailing Address Postal Code:
99703
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
907-361-5758
Provider Business Mailing Address Fax Number:
907-361-4838

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
BASSETT ARMY COMMUNITY HOSPITAL
Provider Second Line Business Practice Location Address:
MEDDAC-ALASKA 1060 GAFFNEY RD #7400
Provider Business Practice Location Address City Name:
FT. WAINWRIGHT
Provider Business Practice Location Address State Name:
AK
Provider Business Practice Location Address Postal Code:
99703-7400
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
907-361-5758
Provider Business Practice Location Address Fax Number:
907-361-4838
Provider Enumeration Date:
06/17/2014

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: 2146334 . This is a "PK" identifier . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com