Provider Demographics
NPI:1649218264
Name:IRWIN ARMY COMMUNITY HOSPITAL
Entity Type:Organization
Organization Name:IRWIN ARMY COMMUNITY HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:UBO MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:DENISE
Authorized Official - Last Name:BUCHMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:785-239-7724
Mailing Address - Street 1:650 HUEBNER RD
Mailing Address - Street 2:ATTN: UNIFORM BUSINESS OFFICE
Mailing Address - City:FORT RILEY
Mailing Address - State:KS
Mailing Address - Zip Code:66442-4030
Mailing Address - Country:US
Mailing Address - Phone:785-239-7000
Mailing Address - Fax:
Practice Address - Street 1:650 HUEBNER RD
Practice Address - Street 2:ATTN: UNIFORM BUSINESS OFFICE
Practice Address - City:FORT RILEY
Practice Address - State:KS
Practice Address - Zip Code:66442-4030
Practice Address - Country:US
Practice Address - Phone:785-239-7000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-04
Last Update Date:2022-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2865M2000XHospitalsMilitary HospitalMilitary General Acute Care Hospital
No261QM1100XAmbulatory Health Care FacilitiesClinic/CenterMilitary/U.S. Coast Guard Outpatient
No261QM1101XAmbulatory Health Care FacilitiesClinic/CenterMilitary and U.S. Coast Guard Ambulatory Procedure
No332000000XSuppliersMilitary/U.S. Coast Guard Pharmacy
No341800000XTransportation ServicesMilitary/U.S. Coast Guard Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS111376OtherBLUE SHIELD
KS514OtherBLUE CROSS
KSAN2598588OtherMEDCO PRESCRIBER ID
KS111376OtherBLUE SHIELD
KSAN2598588OtherMEDCO PRESCRIBER ID