Provider Demographics
NPI: | 1669677456 |
---|---|
Name: | ERMC UNIFORM BUSINESS OFFICE |
Entity Type: | Organization |
Organization Name: | ERMC UNIFORM BUSINESS OFFICE |
Other - Org Name: | USADC DE KLEBER |
Other - Org Type: | Doing Business As |
Authorized Official - Title/Position: | HEALTH SYSTEMS SPEC |
Authorized Official - Prefix: | |
Authorized Official - First Name: | HELEN |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | SNYDER |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 0114963719-464-5471 |
Mailing Address - Street 1: | CMR 402 BLDG 3700 ERMC UBO |
Mailing Address - Street 2: | |
Mailing Address - City: | APO |
Mailing Address - State: | AE |
Mailing Address - Zip Code: | 09180 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 0114963719-464-7400 |
Mailing Address - Fax: | |
Practice Address - Street 1: | CMR 429 |
Practice Address - Street 2: | |
Practice Address - City: | APO |
Practice Address - State: | AE |
Practice Address - Zip Code: | 09054 |
Practice Address - Country: | US |
Practice Address - Phone: | 01149631-411-1720 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | Yes |
Parent Organization LBN: | ERMC UNIFORM BUSINESS OFFICE |
Parent Organization TIN: | <UNAVAIL> |
Enumeration Date: | 2007-06-20 |
Last Update Date: | 2013-02-12 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 261QM1100X | Ambulatory Health Care Facilities | Clinic/Center | Military/U.S. Coast Guard Outpatient |