Provider Demographics
NPI:1568795458
Name:UNITED STATES ARMY HEALTH CLINIC - BAMBERG
Entity Type:Organization
Organization Name:UNITED STATES ARMY HEALTH CLINIC - BAMBERG
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COMMANDER, USAHC BAMBERG
Authorized Official - Prefix:
Authorized Official - First Name:LARRY
Authorized Official - Middle Name:R
Authorized Official - Last Name:PATTERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:01149951-300-8619
Mailing Address - Street 1:USAHC BAMBERG
Mailing Address - Street 2:UNIT 27528
Mailing Address - City:APO
Mailing Address - State:AE
Mailing Address - Zip Code:09139-7528
Mailing Address - Country:US
Mailing Address - Phone:01149954-300-7498
Mailing Address - Fax:01149954-300-3307
Practice Address - Street 1:USAHC BAMBERG
Practice Address - Street 2:UNIT 27528
Practice Address - City:APO
Practice Address - State:AE
Practice Address - Zip Code:09139-7528
Practice Address - Country:US
Practice Address - Phone:01149954-300-7498
Practice Address - Fax:01149954-300-3307
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-10
Last Update Date:2009-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLC 303187261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)