Provider Demographics
NPI:1740359850
Name:KWAJALEIN RANGE SERVICES
Entity type:Organization
Organization Name:KWAJALEIN RANGE SERVICES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHARMACY BUYER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:
Authorized Official - Last Name:MAURER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:805-355-3406
Mailing Address - Street 1:BUILDING 603 OCEAN DRIVE
Mailing Address - Street 2:PO BOX 1702
Mailing Address - City:APO
Mailing Address - State:AP
Mailing Address - Zip Code:96555
Mailing Address - Country:US
Mailing Address - Phone:805-355-3406
Mailing Address - Fax:805-355-1885
Practice Address - Street 1:BUILDING 603 OCEAN DRIVE
Practice Address - Street 2:US ARMY KWAJALEIN ATOLL BOX 1702
Practice Address - City:APO
Practice Address - State:AP
Practice Address - Zip Code:96555
Practice Address - Country:US
Practice Address - Phone:805-355-3406
Practice Address - Fax:805-355-1885
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes286500000XHospitalsMilitary Hospital