# LYSTER ARMY HEALTH CLINIC

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

## Provider details

- **NPI number:** 1255519740
- **Authorized official:** CAROLYN ANN BOOZER (RN)
- **Authorized official phone:** (334) 255-7033

## Contact information

- **Practice address:** ANDREWS AVE, BUILDING 301, FT RUCKER, AL 36362
- **Practice address phone:** (334) 255-7033
- **Mailing address:** ANDREWS AVENUE, BLDG 301, FT RUCKER, AL 36362
- **Mailing address phone:** (334) 255-7033

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM1102X | Military Outpatient Operational (Transportable) Component Clinic/Center | 1-044039 | AL | Yes |

## Other

- **Enumeration date:** 02/06/2008
- **Last updated:** 02/06/2008