1376532861 NPI number — FORCE HEALTH PROTECTION 18TH MEDBN

Table of content: (NPI 1376532861)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1376532861 NPI number — FORCE HEALTH PROTECTION 18TH MEDBN

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
FORCE HEALTH PROTECTION 18TH MEDBN
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:
1376532861
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:
A CO 168TH MED BN(AS)
Provider Second Line Business Mailing Address:
UNIT# 15342
Provider Business Mailing Address City Name:
APO
Provider Business Mailing Address State Name:
AP
Provider Business Mailing Address Postal Code:
96258-5342
Provider Business Mailing Address Country Code:
KR
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
A CO 168TH MED BN(AS)
Provider Second Line Business Practice Location Address:
UNIT# 15342
Provider Business Practice Location Address City Name:
APO
Provider Business Practice Location Address State Name:
AP
Provider Business Practice Location Address Postal Code:
96258-5342
Provider Business Practice Location Address Country Code:
KR
Provider Business Practice Location Address Telephone Number:
310-732-7059
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/18/2005

Additional Information

Authorized Official

Authorized Official Last Name:
BOLTUC
Authorized Official First Name:
KYOUNG
Authorized Official Middle Name:
S
Authorized Official Title or Position:
OCCUPATIONAL HEALTH NURSE
Authorized Official Telephone Number:
310-732-7396

Provider Taxonomy Codes

  • Taxonomy code: 286500000X ; 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