Provider Demographics
NPI:1891982518
Name:JTF-B MED EL-HONDURAS
Entity Type:Organization
Organization Name:JTF-B MED EL-HONDURAS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HQ MEDCOM UBO
Authorized Official - Prefix:
Authorized Official - First Name:JO-EL
Authorized Official - Middle Name:
Authorized Official - Last Name:ONSTAD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-221-8567
Mailing Address - Street 1:UNIT 5700
Mailing Address - Street 2:
Mailing Address - City:APO
Mailing Address - State:AA
Mailing Address - Zip Code:34042
Mailing Address - Country:US
Mailing Address - Phone:011504-234-8641
Mailing Address - Fax:
Practice Address - Street 1:UNIT 5700
Practice Address - Street 2:
Practice Address - City:APO
Practice Address - State:AA
Practice Address - Zip Code:34042
Practice Address - Country:US
Practice Address - Phone:011504-234-8641
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-26
Last Update Date:2014-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1100XAmbulatory Health Care FacilitiesClinic/CenterMilitary/U.S. Coast Guard Outpatient
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAD000Medicare UPIN
OTH000Medicare UPIN