# UNITED STATES NAVY

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1003226309
- **Authorized official:** MR. RANDY SHANARD CUNNINGHAM IDC (INDEPENDENT DUTY CORPSMAN)
- **Authorized official phone:** (205) 936-6013

## Contact information

- **Practice address:** SURFACE WARFARE MEDICAL INSTITUTE, 34101 FARENHOLT AVENUE, BUILDING 14, SAN DIEGO, CA 92134-5291
- **Practice address phone:** (619) 532-7968
- **Mailing address:** SURFACE WARFARE MEDICAL INSTITUTE, 34101 FARENHOLT AVENUE, BUILDING 14, SAN DIEGO, CA 92134-5291
- **Mailing address phone:** (619) 532-7968

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 286500000X | Military Hospital | H01236278 | HI | Yes |

## Other

- **Enumeration date:** 05/07/2014
- **Last updated:** 05/07/2014