Provider Demographics
NPI:1942554373
Name:UNITED STATES NAVY
Entity Type:Organization
Organization Name:UNITED STATES NAVY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:QUALITY MANAGEMENT DEPARTMENT
Authorized Official - Prefix:MR
Authorized Official - First Name:TOM
Authorized Official - Middle Name:
Authorized Official - Last Name:COLGAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:760-725-8882
Mailing Address - Street 1:H100 SANTA MARGARITA ROAD
Mailing Address - Street 2:ATTENTION: CODE 00QM
Mailing Address - City:CAMP PENDLETON
Mailing Address - State:CA
Mailing Address - Zip Code:92055-5191
Mailing Address - Country:US
Mailing Address - Phone:760-725-2903
Mailing Address - Fax:760-725-1267
Practice Address - Street 1:H100 SANTA MARGARITA ROAD
Practice Address - Street 2:ATTENTION: CODE 00QM
Practice Address - City:CAMP PENDLETON
Practice Address - State:CA
Practice Address - Zip Code:92055-5191
Practice Address - Country:US
Practice Address - Phone:760-725-2903
Practice Address - Fax:760-725-1267
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-07
Last Update Date:2012-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI286500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes286500000XHospitalsMilitary Hospital