Provider Demographics
NPI:1720214554
Name:IRWIN ARMY COMMUNITY HOSPITAL
Entity Type:Organization
Organization Name:IRWIN ARMY COMMUNITY HOSPITAL
Other - Org Name:USADC FT. RILEY 2
Other - Org Type:Doing Business As
Authorized Official - Title/Position:UBO MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:
Authorized Official - Last Name:BUCHMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:785-239-7724
Mailing Address - Street 1:600 CAISSON HILL RD
Mailing Address - Street 2:ATTN UBO
Mailing Address - City:FORT RILEY
Mailing Address - State:KS
Mailing Address - Zip Code:66442-7037
Mailing Address - Country:US
Mailing Address - Phone:785-239-7724
Mailing Address - Fax:
Practice Address - Street 1:602 HUEBNER RD
Practice Address - Street 2:US ARMY DENTAL CLINIC 2
Practice Address - City:FORT RILEY
Practice Address - State:KS
Practice Address - Zip Code:66442-4030
Practice Address - Country:US
Practice Address - Phone:785-239-7955
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:IRWIN ARMY COMMUNITY HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-06-08
Last Update Date:2013-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1100XAmbulatory Health Care FacilitiesClinic/CenterMilitary/U.S. Coast Guard Outpatient