NPI 1619403748

Glwach

Organisation Military Hospital Fort Leonard Wood, MO

Practice location

Address: 4430 Missouri Ave Glwach, Fort Leonard Wood, MO 65473-9098
Phone: (573) 596-0515
Mailing address: 118a Edna, Waynesville, MO 65583-7875

Authorised official

Name: Ude U Ude
Title: Pharmacist
Phone: 31456005329

Registered specialties

Military Hospital Primary

Hospitals Taxonomy 286500000X Licence 2013031924 (MO)

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Registry record

NPI: 1619403748
Entity type: Organization
NPI issued: 10 May 2017
Record last updated: 10 May 2017

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.