Organization Name: | WILFORD HALL MEDICAL CENTER |
NPI Number: | 1861467193 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | DARLENE JACKSON (CREDENTIALS MANAGER) |
Mailing Address: | 2200 Bergquist Dr Attn: Credentials (cmc) Lackland A F B |
State: | TX US |
Postal Code: | 782369907 |
Phone Number: | 2102926707 |
Fax Number: | 2102927964 |
NPI Enumeration Date: | 02/21/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 286500000X |
License Number: | 40761 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Hospitals |
Taxonomy Classification: | Military Hospital |
Taxonomy Specialization: | |
Taxonomy Definition: | A health care facility operated by the Department of Defense. |