Provider Demographics
NPI:1619336187
Name:AMERICAN SAMOA TROPICAL MEDICAL CENTER
Entity Type:Organization
Organization Name:AMERICAN SAMOA TROPICAL MEDICAL CENTER
Other - Org Name:LBJ TMC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ANESTHESIOLOGIST
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:AITOFELE
Authorized Official - Suffix:
Authorized Official - Credentials:MBBS
Authorized Official - Phone:684-633-1222
Mailing Address - Street 1:1 TURNER DRIVE
Mailing Address - Street 2:
Mailing Address - City:PAGO PAGO
Mailing Address - State:AS
Mailing Address - Zip Code:96799-9994
Mailing Address - Country:US
Mailing Address - Phone:684-633-1222
Mailing Address - Fax:684-633-1222
Practice Address - Street 1:1 TURNER DRIVE
Practice Address - Street 2:
Practice Address - City:PAGO PAGO
Practice Address - State:AS
Practice Address - Zip Code:96799-9994
Practice Address - Country:US
Practice Address - Phone:684-633-1222
Practice Address - Fax:684-633-2893
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-12
Last Update Date:2016-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AS2049-A282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital