Organization · NPI-2

Wach,fort Stewart,ga

Military Hospital · Fort Stewart, GA

NPI number1093714461
StatusActive
Last updated in NPPESAug 22, 2020

Details

NPI
1093714461
Entity type
Organization (NPI-2)
Legal business name
Wach,fort Stewart,ga
Organization subpart
No
Enumeration date
Jul 19, 2005
Last updated
Aug 22, 2020

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
286500000X Military HospitalRN118721GAYes

Practice location

1061 Harmon Ave
Suite 1 Do3 Pediatric Clinic
Fort Stewart, GA 31314-5604

Phone 912-435-5555

Mailing address

501 Creek View Dr
Hinesville, GA 31313-3314

Phone 912-876-2107

Authorized official

Maria S. Rodriguez
Clinical Nurse
9124355555

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