Provider Demographics
NPI:1336119403
Name:DOD
Entity Type:Organization
Organization Name:DOD
Other - Org Name:EVAVNS ARMY COMMUNITY HOSPITAL
Other - Org Type:Other Name
Authorized Official - Title/Position:MEDICAL OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:YASHODA
Authorized Official - Middle Name:BT
Authorized Official - Last Name:SAGAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:710-524-4289
Mailing Address - Street 1:710 HERBGLEN CT
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80906-7692
Mailing Address - Country:US
Mailing Address - Phone:710-540-9745
Mailing Address - Fax:
Practice Address - Street 1:7500 COCHRANE CIR
Practice Address - Street 2:FT.CARSON
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80913-7692
Practice Address - Country:US
Practice Address - Phone:710-524-4289
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM78-82261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center