Provider Demographics
NPI:1457742785
Name:BROOKE ARMY MEDICAL CENTER
Entity Type:Organization
Organization Name:BROOKE ARMY MEDICAL CENTER
Other - Org Name:FT SAM CBPCC WH PHCY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF, UNIFORM BUSINESS OFFICE
Authorized Official - Prefix:
Authorized Official - First Name:NORA
Authorized Official - Middle Name:
Authorized Official - Last Name:ALPIZAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-916-8563
Mailing Address - Street 1:BROOKE ARMY MEDICAL CENTER
Mailing Address - Street 2:3551 ROGER BROOKE DR MCHE-ZAR-UT 201
Mailing Address - City:FORT SAM HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:78234-4513
Mailing Address - Country:US
Mailing Address - Phone:210-916-8563
Mailing Address - Fax:210-916-4851
Practice Address - Street 1:10010 ROGERS RUN
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78251-4403
Practice Address - Country:US
Practice Address - Phone:210-916-2872
Practice Address - Fax:210-916-2124
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-09
Last Update Date:2018-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes286500000XHospitalsMilitary Hospital
No332000000XSuppliersMilitary/U.S. Coast Guard Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2150116OtherPK