Provider Demographics
NPI:1497842074
Name:OSPWEED ARMYCOMMUNITY
Entity Type:Organization
Organization Name:OSPWEED ARMYCOMMUNITY
Other - Org Name:AMERICAN RED CROSS
Other - Org Type:Other Name
Authorized Official - Title/Position:REDCROSS VOLUNTEER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DORIS
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:DULA
Authorized Official - Suffix:
Authorized Official - Credentials:LVN
Authorized Official - Phone:910-273-9578
Mailing Address - Street 1:5220B SILVER MINE WAY
Mailing Address - Street 2:
Mailing Address - City:FORT IRWIN
Mailing Address - State:CA
Mailing Address - Zip Code:92310-2103
Mailing Address - Country:US
Mailing Address - Phone:760-380-3185
Mailing Address - Fax:760-380-6783
Practice Address - Street 1:5220B SILVER MINE WAY
Practice Address - Street 2:
Practice Address - City:FORT IRWIN
Practice Address - State:CA
Practice Address - Zip Code:92310-2103
Practice Address - Country:US
Practice Address - Phone:760-380-3185
Practice Address - Fax:760-380-6783
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0647633140N1450X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3140N1450XNursing & Custodial Care FacilitiesSkilled Nursing FacilityNursing Care, Pediatric