Organization Name: | WEED ARMY COMMUNITY HOSPITAL |
NPI Number: | 1275618514 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | DERRECK SUMMERS (C, PAD) |
Mailing Address: | Bldg 166 Fort Irwin |
State: | CA US |
Postal Code: | 923105109 |
Phone Number: | 7603803124 |
Fax Number: | |
NPI Enumeration Date: | 10/26/2006 |
NPI Last Update Date: | 04/07/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QM1100X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
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 |