Provider Demographics
NPI:1063642668
Name:BRIAN ALLGOOD COMMUNITY HOSPITAL
Entity Type:Organization
Organization Name:BRIAN ALLGOOD COMMUNITY HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PUBLIC HEALTH NURSE
Authorized Official - Prefix:MS
Authorized Official - First Name:ANA
Authorized Official - Middle Name:MARITZA
Authorized Official - Last Name:FOSTER
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:210-745-2368
Mailing Address - Street 1:121 CSH BOX 372
Mailing Address - Street 2:UNIT 15244 APO AP
Mailing Address - City:YONGSAN
Mailing Address - State:SEOUL
Mailing Address - Zip Code:96205
Mailing Address - Country:KR
Mailing Address - Phone:315-736-6693
Mailing Address - Fax:
Practice Address - Street 1:121 COMBAT SUPPORT HOSPITAL
Practice Address - Street 2:UNIT 15244
Practice Address - City:APO
Practice Address - State:AP
Practice Address - Zip Code:96205
Practice Address - Country:US
Practice Address - Phone:315-373-3203
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-17
Last Update Date:2009-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY489631261QC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health