Provider Demographics
NPI:1942503081
Name:US NAVY
Entity Type:Organization
Organization Name:US NAVY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:IDEPENDENT DUTY CORPSMAN
Authorized Official - Prefix:MR
Authorized Official - First Name:JASON
Authorized Official - Middle Name:STUART
Authorized Official - Last Name:HARRIS
Authorized Official - Suffix:
Authorized Official - Credentials:IDC
Authorized Official - Phone:315-637-1250
Mailing Address - Street 1:3D MLG CLR37 KGAS
Mailing Address - Street 2:UNIT 38404
Mailing Address - City:FPO
Mailing Address - State:AP
Mailing Address - Zip Code:96604-8404
Mailing Address - Country:US
Mailing Address - Phone:315-637-1250
Mailing Address - Fax:
Practice Address - Street 1:3D MLG CLR 37 KGAS
Practice Address - Street 2:UNIT 38404
Practice Address - City:FPO
Practice Address - State:AP
Practice Address - Zip Code:96604-8404
Practice Address - Country:US
Practice Address - Phone:315-637-1250
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-13
Last Update Date:2010-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes286500000XHospitalsMilitary Hospital