Provider Demographics
NPI:1871664060
Name:US NAVY
Entity Type:Organization
Organization Name:US NAVY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NOMI CREDENTIALS, PENSACOLA, FL
Authorized Official - Prefix:MRS
Authorized Official - First Name:ELEANOR
Authorized Official - Middle Name:
Authorized Official - Last Name:REEVES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:850-452-9484
Mailing Address - Street 1:2792 COTTONWOOD LN
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32514-5917
Mailing Address - Country:US
Mailing Address - Phone:708-370-1616
Mailing Address - Fax:
Practice Address - Street 1:340 HULSE RD BLDG 665 SUITE 105
Practice Address - Street 2:850-452-8051
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32508-1089
Practice Address - Country:US
Practice Address - Phone:850-452-8051
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101240250261QM1100X, 286500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered261QM1100XAmbulatory Health Care FacilitiesClinic/CenterMilitary/U.S. Coast Guard Outpatient
Not Answered286500000XHospitalsMilitary Hospital