Provider Demographics
NPI:1609017235
Name:WOMACK ARMY MEDICAL CENTER
Entity Type:Organization
Organization Name:WOMACK ARMY MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OF MEDICAL RESIDENTS
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:
Authorized Official - Last Name:KIM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:202-782-5584
Mailing Address - Street 1:2817 REILLY ROAD
Mailing Address - Street 2:BUILDING 4
Mailing Address - City:FORT BRAGG
Mailing Address - State:NC
Mailing Address - Zip Code:28307
Mailing Address - Country:US
Mailing Address - Phone:910-907-9262
Mailing Address - Fax:
Practice Address - Street 1:2817 REILLY ROAD
Practice Address - Street 2:BUILDING 4
Practice Address - City:FORT BRAGG
Practice Address - State:NC
Practice Address - Zip Code:28307
Practice Address - Country:US
Practice Address - Phone:910-907-9262
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-11
Last Update Date:2012-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2865M2000XHospitalsMilitary HospitalMilitary General Acute Care Hospital