Provider Demographics
NPI:1427217447
Name:BASSETT ARMY COMMUNITY HOSPITAL
Entity Type:Organization
Organization Name:BASSETT ARMY COMMUNITY HOSPITAL
Other - Org Name:GREELY 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:BASSETT ARMY COMMUNITY HOSPITAL
Mailing Address - Street 2:1060 GAFFNEY RD 7420
Mailing Address - City:FT WAINWRIGHT
Mailing Address - State:AK
Mailing Address - Zip Code:99703
Mailing Address - Country:US
Mailing Address - Phone:907-873-3335
Mailing Address - Fax:
Practice Address - Street 1:131DG 661 ARTIC AVE
Practice Address - Street 2:
Practice Address - City:FR GREELY
Practice Address - State:AK
Practice Address - Zip Code:99731
Practice Address - Country:US
Practice Address - Phone:907-873-3335
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-05
Last Update Date:2015-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332000000XSuppliersMilitary/U.S. Coast Guard Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
1997275OtherPK
0202375OtherNCPDP