Provider Demographics
NPI:1467864090
Name:WEED ARMY COMMUNITY HOSPITAL
Entity Type:Organization
Organization Name:WEED ARMY COMMUNITY HOSPITAL
Other - Org Name:DOD YUMA PG PHARMACY
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:WEED ARMY COMMUNITY HOSPITA
Mailing Address - Street 2:PO BOX 105109
Mailing Address - City:FT IRWIN
Mailing Address - State:CA
Mailing Address - Zip Code:92310
Mailing Address - Country:US
Mailing Address - Phone:928-328-2345
Mailing Address - Fax:928-328-3838
Practice Address - Street 1:301 C ST BLDG 990
Practice Address - Street 2:US ARMY HEALTH CLINIC,YUMA PROVING GROUND
Practice Address - City:YPG
Practice Address - State:AZ
Practice Address - Zip Code:85365-9498
Practice Address - Country:US
Practice Address - Phone:928-328-2345
Practice Address - Fax:928-328-3838
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-02
Last Update Date:2021-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332000000XSuppliersMilitary/U.S. Coast Guard Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2146019OtherPK