Provider Demographics
NPI:1447664727
Name:BAYNE JONES ARMY COMMUNITY HOSPITAL
Entity type:Organization
Organization Name:BAYNE JONES ARMY COMMUNITY HOSPITAL
Other - Org Name:<UNAVAIL>
Other - Org Type:
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:BAYNE JONES ARMY COMMUNITY HOSPITAL
Mailing Address - Street 2:1585 3RD STREE BUILDING 285
Mailing Address - City:FORT POLK
Mailing Address - State:LA
Mailing Address - Zip Code:71459-5102
Mailing Address - Country:US
Mailing Address - Phone:337-531-8090
Mailing Address - Fax:337-531-3614
Practice Address - Street 1:1585 3RD ST BLDG 285
Practice Address - Street 2:BAYNE JONES ARMY COMMUNITY HOSPITAL
Practice Address - City:FORT POLK
Practice Address - State:LA
Practice Address - Zip Code:71459-5102
Practice Address - Country:US
Practice Address - Phone:337-531-8090
Practice Address - Fax:337-531-3614
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-16
Last Update Date:2016-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332000000XSuppliersMilitary/U.S. Coast Guard Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2146245OtherPK