Provider Demographics
NPI:1982819785
Name:CARL R DARNALL ARMY MEDICAL CENTER
Entity Type:Organization
Organization Name:CARL R DARNALL ARMY MEDICAL CENTER
Other - Org Name:BENNETT FAMILY CARE CLINIC-HOOD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:LEAD HEALTH INSURANCE TECHNICIAN
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:ROPPLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:254-288-8381
Mailing Address - Street 1:36065 SANTA FE AVE
Mailing Address - Street 2:BOX 313
Mailing Address - City:FORT HOOD
Mailing Address - State:TX
Mailing Address - Zip Code:76544-5060
Mailing Address - Country:US
Mailing Address - Phone:254-288-8381
Mailing Address - Fax:
Practice Address - Street 1:31ST ST AND BATTALION AVE
Practice Address - Street 2:BENNETT CLINIC
Practice Address - City:FORT HOOD
Practice Address - State:TX
Practice Address - Zip Code:76544
Practice Address - Country:US
Practice Address - Phone:254-618-8040
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CARL R DARNALL ARMY MEDICAL CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-05-14
Last Update Date:2018-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1100XAmbulatory Health Care FacilitiesClinic/CenterMilitary/U.S. Coast Guard Outpatient
No332000000XSuppliersMilitary/U.S. Coast Guard Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
OTH000Medicare UPIN
VAD000Medicare UPIN