# WACH,FORT STEWART,GA

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

## Provider details

- **NPI number:** 1093714461
- **Authorized official:** MRS. MARIA S. RODRIGUEZ R.N. (CLINICAL NURSE)
- **Authorized official phone:** (912) 435-5555

## Contact information

- **Practice address:** 1061 HARMON AVE, SUITE 1 DO3 PEDIATRIC CLINIC, FORT STEWART, GA 31314-5604
- **Practice address phone:** (912) 435-5555
- **Mailing address:** 501 CREEK VIEW DR, HINESVILLE, GA 31313-3314
- **Mailing address phone:** (912) 876-2107

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 286500000X | Military Hospital | RN118721 | GA | Yes |

## Other

- **Enumeration date:** 07/19/2005
- **Last updated:** 08/22/2020