Provider Demographics
NPI:1508856212
Name:DCSFHP, OHS, 18TH MEDCOM
Entity Type:Organization
Organization Name:DCSFHP, OHS, 18TH MEDCOM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OCCUPATIONAL HEALTH NURSE
Authorized Official - Prefix:MRS
Authorized Official - First Name:KUN AI
Authorized Official - Middle Name:
Authorized Official - Last Name:CHO
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:053-470-5567
Mailing Address - Street 1:HSC 168TH MED BN, UNIT 15021, BOX 10-B
Mailing Address - Street 2:
Mailing Address - City:APO
Mailing Address - State:AP
Mailing Address - Zip Code:96218
Mailing Address - Country:KR
Mailing Address - Phone:053-470-5567
Mailing Address - Fax:
Practice Address - Street 1:168TH MED BN UNIT 15021, BOX 10-B
Practice Address - Street 2:
Practice Address - City:APO
Practice Address - State:AP
Practice Address - Zip Code:96218
Practice Address - Country:US
Practice Address - Phone:0118253-764-5567
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-25
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001131457261QM1100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1100XAmbulatory Health Care FacilitiesClinic/CenterMilitary/U.S. Coast Guard Outpatient