Provider Demographics
NPI:1477058840
Name:INTERNATIONAL SOS GOVERNMENT MEDICAL SERVICES, INC.
Entity type:Organization
Organization Name:INTERNATIONAL SOS GOVERNMENT MEDICAL SERVICES, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:GENERAL MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:HASS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:202-320-9092
Mailing Address - Street 1:708 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77002-3208
Mailing Address - Country:US
Mailing Address - Phone:202-320-9092
Mailing Address - Fax:
Practice Address - Street 1:KWAJALEIN HOSPITAL
Practice Address - Street 2:UNIT 45081
Practice Address - City:APO
Practice Address - State:AP
Practice Address - Zip Code:96555-5801
Practice Address - Country:US
Practice Address - Phone:805-355-2224
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-28
Last Update Date:2019-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes286500000XHospitalsMilitary Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
MHL000002MHL0000OtherTRICARE PROVIDER ENCOUNTER RECORD VALIDATION