| Organization Name: | BARQUIST ARMY HEALTH CLINIC |
| NPI Number: | 1821470774 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | PRASATHIP VONGXAY-SANO (STAFF PHARMACIST) |
| Mailing Address: | 1434 Porter St Fort Detrick |
| State: | MD US |
| Postal Code: | 217029254 |
| Phone Number: | 3016197175 |
| Fax Number: | |
| NPI Enumeration Date: | 06/26/2015 |
| NPI Last Update Date: | 06/26/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QC1500X |
| License Number: | 11850 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NC |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Community Health |
| Taxonomy Definition: | |