Provider Demographics
NPI:1497152045
Name:NAVAL HOSPITAL LEMOORE
Entity Type:Organization
Organization Name:NAVAL HOSPITAL LEMOORE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL STAFF SERVICES PROFESSIONAL
Authorized Official - Prefix:
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:
Authorized Official - Last Name:REESE-CONVER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:559-998-4262
Mailing Address - Street 1:937 FRANKLIN AVENUE
Mailing Address - Street 2:
Mailing Address - City:LEMOORE
Mailing Address - State:CA
Mailing Address - Zip Code:93246
Mailing Address - Country:US
Mailing Address - Phone:559-998-4262
Mailing Address - Fax:
Practice Address - Street 1:937 FRANKLIN AVENUE
Practice Address - Street 2:
Practice Address - City:FPO
Practice Address - State:AA
Practice Address - Zip Code:93246
Practice Address - Country:US
Practice Address - Phone:559-998-4262
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-25
Last Update Date:2014-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN5831286500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes286500000XHospitalsMilitary Hospital