Provider Demographics
NPI:1548401862
Name:U.S. ARMY
Entity Type:Organization
Organization Name:U.S. ARMY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HEAD NURSE
Authorized Official - Prefix:MS
Authorized Official - First Name:HYON
Authorized Official - Middle Name:SUK
Authorized Official - Last Name:QUATTLEBAUM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:011-737-6015
Mailing Address - Street 1:A CO, 121ST CSH, BOX 6
Mailing Address - Street 2:
Mailing Address - City:APO
Mailing Address - State:AP
Mailing Address - Zip Code:96205
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:A CO, 121ST CSH, BOX 6 , UNIT 15244
Practice Address - Street 2:
Practice Address - City:APO
Practice Address - State:AP
Practice Address - Zip Code:96205-5244
Practice Address - Country:US
Practice Address - Phone:011-737-6015
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-17
Last Update Date:2009-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX666188286500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes286500000XHospitalsMilitary Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX=========OtherTRICARE