Provider Demographics
NPI:1316554645
Name:BAYNES-JONES ARMY COMMUNITY HOSPITAL
Entity Type:Organization
Organization Name:BAYNES-JONES ARMY COMMUNITY HOSPITAL
Other - Org Name:POLK CBPCC PHCY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF DHA PASS
Authorized Official - Prefix:
Authorized Official - First Name:HECTOR
Authorized Official - Middle Name:
Authorized Official - Last Name:MORALES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-536-6650
Mailing Address - Street 1:2050 DRAGOON LOOP BLDG 2060
Mailing Address - Street 2:
Mailing Address - City:FORT POLK
Mailing Address - State:LA
Mailing Address - Zip Code:71459-5242
Mailing Address - Country:US
Mailing Address - Phone:337-531-1046
Mailing Address - Fax:
Practice Address - Street 1:1585 3RD ST BLDG 285
Practice Address - Street 2:
Practice Address - City:FORT POLK
Practice Address - State:LA
Practice Address - Zip Code:71459-5102
Practice Address - Country:US
Practice Address - Phone:337-531-3158
Practice Address - Fax:337-531-3158
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BAYNES-JONES ARMY COMMUNITY HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-09-30
Last Update Date:2020-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332000000XSuppliersMilitary/U.S. Coast Guard Pharmacy