Provider Demographics
NPI:1982703245
Name:REYNOLDS ARMY COMMUNITY HOSPITAL
Entity Type:Organization
Organization Name:REYNOLDS ARMY COMMUNITY HOSPITAL
Other - Org Name:MCALESTER PHCY
Other - Org Type:Doing Business As
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:REYNOLDS ARMY COMMUNITY HOSPITAL MCUA-PAD-PF
Mailing Address - Street 2:3009 NW WILSON RD
Mailing Address - City:FORT SILL
Mailing Address - State:OK
Mailing Address - Zip Code:73503
Mailing Address - Country:US
Mailing Address - Phone:918-420-7496
Mailing Address - Fax:
Practice Address - Street 1:US ARMY HEALTH CLINIC AAR MCALESTER
Practice Address - Street 2:IC TREE ROAD
Practice Address - City:MCALESTER
Practice Address - State:OK
Practice Address - Zip Code:74301-5000
Practice Address - Country:US
Practice Address - Phone:918-420-7496
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-22
Last Update Date:2015-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332000000XSuppliersMilitary/U.S. Coast Guard Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2076575OtherPK
1487752960OtherPARENT NPI