Provider Demographics
NPI:1881821247
Name:FCC POLLOCK
Entity Type:Organization
Organization Name:FCC POLLOCK
Other - Org Name:FEDERAL BUREAU OF PRISONS
Other - Org Type:Other Name
Authorized Official - Title/Position:HEALTH SERVICES ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:SPENCER
Authorized Official - Middle Name:TALMADGE
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:318-561-5546
Mailing Address - Street 1:P.O. 1000
Mailing Address - Street 2:HEALTH SERVICES
Mailing Address - City:POLLOCK
Mailing Address - State:LA
Mailing Address - Zip Code:71467-1000
Mailing Address - Country:US
Mailing Address - Phone:318-561-5546
Mailing Address - Fax:318-561-5547
Practice Address - Street 1:1000 AIR BASE ROAD
Practice Address - Street 2:HEALTH SERVICES
Practice Address - City:POLLOCK
Practice Address - State:LA
Practice Address - Zip Code:71467-1000
Practice Address - Country:US
Practice Address - Phone:318-561-5546
Practice Address - Fax:318-561-5547
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-12
Last Update Date:2009-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2400XAmbulatory Health Care FacilitiesClinic/CenterPrison Health