Provider Demographics
NPI:1003350687
Name:MADIGAN ARMY MEDICAL CENTER
Entity Type:Organization
Organization Name:MADIGAN ARMY MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL SERVICES ACCOUNT OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:TELESIA
Authorized Official - Middle Name:
Authorized Official - Last Name:MULIAGATELE-PLUMMER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:253-968-1684
Mailing Address - Street 1:9040A JACKSON AVE
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98431-0001
Mailing Address - Country:US
Mailing Address - Phone:253-968-1684
Mailing Address - Fax:
Practice Address - Street 1:9040A JACKSON AVE
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98431-0001
Practice Address - Country:US
Practice Address - Phone:253-968-1684
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-15
Last Update Date:2016-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2865X1600XHospitalsMilitary HospitalMilitary General Acute Care Hospital. Operational (Transportable)
Provider Identifiers
StateIdentifier IDID TypeIssuer
1841390077OtherMILITARY HOSPITAL