Provider Demographics
NPI:1659600476
Name:WOMACK ARMY MEDICAL CENTER
Entity Type:Organization
Organization Name:WOMACK ARMY MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DEVELOPMENTAL PEDIATRICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:WATSON
Authorized Official - Last Name:COOPER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:910-391-3856
Mailing Address - Street 1:WOMACK ARMY MEDICAL CTR
Mailing Address - Street 2:ATTN: MCXC-DPC-EF
Mailing Address - City:FORT BRAGG
Mailing Address - State:NC
Mailing Address - Zip Code:28310-5000
Mailing Address - Country:US
Mailing Address - Phone:910-907-8071
Mailing Address - Fax:910-907-8752
Practice Address - Street 1:WOMACK ARMY MEDICAL CTR
Practice Address - Street 2:ATTN: MCXC-DPC-EF
Practice Address - City:FORT BRAGG
Practice Address - State:NC
Practice Address - Zip Code:28310-5000
Practice Address - Country:US
Practice Address - Phone:910-907-8071
Practice Address - Fax:910-907-8752
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-08
Last Update Date:2009-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC50044952865M2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2865M2000XHospitalsMilitary HospitalMilitary General Acute Care Hospital