Provider Demographics
NPI:1801039417
Name:IRELAND ARMY COMMUNITY HOSPITAL
Entity Type:Organization
Organization Name:IRELAND ARMY COMMUNITY HOSPITAL
Other - Org Name:CAMP ATTERBURY PHCY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF DHA PASS
Authorized Official - Prefix:
Authorized Official - First Name:HECTOR
Authorized Official - Middle Name:
Authorized Official - Last Name:MORALES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-536-6650
Mailing Address - Street 1:289 IRELAND AVE
Mailing Address - Street 2:ATTN: TREASURER OFFICE
Mailing Address - City:FORT KNOX
Mailing Address - State:KY
Mailing Address - Zip Code:40121-5111
Mailing Address - Country:US
Mailing Address - Phone:502-624-9274
Mailing Address - Fax:
Practice Address - Street 1:EVANS ROAD
Practice Address - Street 2:BLDG 2
Practice Address - City:CAMP ATTERBURY
Practice Address - State:IN
Practice Address - Zip Code:46124-5000
Practice Address - Country:US
Practice Address - Phone:812-526-1499
Practice Address - Fax:812-526-1178
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-13
Last Update Date:2015-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332000000XSuppliersMilitary/U.S. Coast Guard Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2119981OtherPK
1891899274OtherPARENT FACILITY NPI
1740496124OtherFACILITY NPI