Organization Name: | KELLER ARMY COMMUNITY HOSPITAL |
NPI Number: | 1124234935 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | KENNETH TUFFY (UBO MANAGER) |
Mailing Address: | 900 Washington Rd Bldg 606 West Point |
State: | NY US |
Postal Code: | 109961109 |
Phone Number: | 8459386655 |
Fax Number: | |
NPI Enumeration Date: | 05/16/2007 |
NPI Last Update Date: | 12/23/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QM1100X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Military/U.S. Coast Guard Outpatient |
Taxonomy Definition: | The Defense Health Program or U.S. Coast Guard funded |