1689782021 NPI number — USAMEDDAC WUERZBERG,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 1689782021 NPI number — USAMEDDAC WUERZBERG,UNIT 26610

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
USAMEDDAC WUERZBERG,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:
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:
1689782021
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:
CMR415
Provider Second Line Business Mailing Address:
BOX 5021
Provider Business Mailing Address City Name:
APO
Provider Business Mailing Address State Name:
AE
Provider Business Mailing Address Postal Code:
09114
Provider Business Mailing Address Country Code:
DE
Provider Business Mailing Address Telephone Number:
011499641837426
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
GRAFENWOHER HEALTH CLINIC
Provider Second Line Business Practice Location Address:
CMR 415; BOX 5021
Provider Business Practice Location Address City Name:
APO
Provider Business Practice Location Address State Name:
AE
Provider Business Practice Location Address Postal Code:
09114
Provider Business Practice Location Address Country Code:
DE
Provider Business Practice Location Address Telephone Number:
011499641837426
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/27/2006

Additional Information

Authorized Official

Authorized Official Last Name:
CASEY
Authorized Official First Name:
AMERICA
Authorized Official Middle Name:
Authorized Official Title or Position:
NURSE
Authorized Official Telephone Number:
09641837426

Provider Taxonomy Codes

  • Taxonomy code: 313M00000X , with the licence number:  28158207A , registered in the state of IN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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