NPI 1205145695

US Army

Organisation Operational (Transportable) Military General Acute Care Hospital Fort Campbell, KY

Practice location

Address: 650 Joel Dr C/O Don Black, Blue Clinic, Fort Campbell, KY 42223-5318
Phone: (270) 956-0178
Mailing address: 3110 Lylewood Rd, Woodlawn, TN 37191-8232

Authorised official

Name: Donald Black
Title: Ipap Phase 2 Director
Phone: (270) 956-0178

Registered specialties

Operational (Transportable) Military General Acute Care Hospital Primary

Hospitals Taxonomy 2865X1600X

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Registry record

NPI: 1205145695
Entity type: Organization
NPI issued: 1 Oct 2010
Record last updated: 1 Oct 2010

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.