Organization Name: | MEDDAC-WACH |
NPI Number: | 1720018757 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | MARITSA IRBY (LPN) |
Mailing Address: | 5092 Superior Valley Ct # B Fort Irwin |
State: | CA US |
Postal Code: | 923102046 |
Phone Number: | 7603868320 |
Fax Number: | |
NPI Enumeration Date: | 07/04/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 286500000X |
License Number: | PN5167255 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Hospitals |
Taxonomy Classification: | Military Hospital |
Taxonomy Specialization: | |
Taxonomy Definition: | A health care facility operated by the Department of Defense. |