1467551184 NPI number — WRAMC

Table of content: (NPI 1467551184)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1467551184 NPI number — WRAMC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
WRAMC
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:
1467551184
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/28/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
9300 DEWITT LOOP
Provider Second Line Business Mailing Address:
C/O FBCH OTPT TPCP
Provider Business Mailing Address City Name:
FT BELVOIR
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
22060-5285
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
703-692-8692
Provider Business Mailing Address Fax Number:
703-697-4572

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1501 DEFENSE PENTAGON
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WASHINGTON
Provider Business Practice Location Address State Name:
DC
Provider Business Practice Location Address Postal Code:
20310-0001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
703-692-8692
Provider Business Practice Location Address Fax Number:
703-697-4572
Provider Enumeration Date:
09/21/2006

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: 2004804 . This is a "PK" identifier . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com