Provider Demographics
NPI:1518912823
Name:NAVAL HOSPITAL GUANTANAMO BAY
Entity Type:Organization
Organization Name:NAVAL HOSPITAL GUANTANAMO BAY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NAVY MEDICINE UBO PROGRAM MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:CONDON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:240-401-3643
Mailing Address - Street 1:PSC 810
Mailing Address - Street 2:
Mailing Address - City:FPO
Mailing Address - State:AE
Mailing Address - Zip Code:09589
Mailing Address - Country:US
Mailing Address - Phone:757-458-2998
Mailing Address - Fax:0115-399-2252
Practice Address - Street 1:USNH COMMANDING OFFICE
Practice Address - Street 2:PATIENT ACCOUNTS
Practice Address - City:FPO
Practice Address - State:AE
Practice Address - Zip Code:09589
Practice Address - Country:US
Practice Address - Phone:01153-997-2230
Practice Address - Fax:0115-399-2252
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NAVAL HOSPITAL GUANTANAMO BAY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-05-24
Last Update Date:2019-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2865M2000XHospitalsMilitary HospitalMilitary General Acute Care Hospital