Provider Demographics
NPI:1023117066
Name:REYNOLDS ARMY COMMUNITY HOSPITAL
Entity type:Organization
Organization Name:REYNOLDS ARMY COMMUNITY HOSPITAL
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF DHA PASS
Authorized Official - Prefix:
Authorized Official - First Name:HECTOR
Authorized Official - Middle Name:
Authorized Official - Last Name:MORALES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-536-6650
Mailing Address - Street 1:10020 KABRICH CIR
Mailing Address - Street 2:
Mailing Address - City:PINE BLUFF
Mailing Address - State:AR
Mailing Address - Zip Code:71602-9031
Mailing Address - Country:US
Mailing Address - Phone:870-540-3413
Mailing Address - Fax:580-458-2445
Practice Address - Street 1:10020 KABRICH CIR
Practice Address - Street 2:
Practice Address - City:PINE BLUFF
Practice Address - State:AR
Practice Address - Zip Code:71602-9031
Practice Address - Country:US
Practice Address - Phone:870-540-3413
Practice Address - Fax:580-458-2445
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-22
Last Update Date:2016-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332000000XSuppliersMilitary/U.S. Coast Guard Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
1989282OtherPK
1487752960OtherPARENT NPI