Basic Information
| Provider Information | |||||||||
| NPI: | 1457781833 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | WINN ARMY COMMUNITY HOSPITAL | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1061 HARMON AVE | ||||||||
| Address2: | WINN ARMY COMMUNITY HOSPITAL | ||||||||
| City: | FORT STEWART | ||||||||
| State: | GA | ||||||||
| PostalCode: | 313145641 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9124356933 | ||||||||
| FaxNumber: | 9124355966 | ||||||||
| Practice Location | |||||||||
| Address1: | 1061 HARMON AVE | ||||||||
| Address2: | WINN ARMY COMMUNITY HOSPITAL; CREDENTIALS OFFICE | ||||||||
| City: | FORT STEWART | ||||||||
| State: | GA | ||||||||
| PostalCode: | 313145641 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9124356933 | ||||||||
| FaxNumber: | 9124355966 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/20/2013 | ||||||||
| LastUpdateDate: | 11/20/2013 | ||||||||
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| AuthorizedOfficialLastName: | ODOM | ||||||||
| AuthorizedOfficialFirstName: | BRENDA | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | CREDENTIALS MANAGER | ||||||||
| AuthorizedOfficialTelephone: | 9124356933 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 286500000X | C008473 | NC | Y | Hospitals | Military Hospital |
No ID Information.