# BLANCHFIELD ARMY COMMUNITY HOSPITAL

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** BLANCHFIELD ARMY COMMUNITY HOSPITAL
- **Other names:** SCREAMING EAGLE MEDICAL HOME-CAMPB
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1275846263
- **Legal business name:** BLANCHFIELD ARMY COMMUNITY HOSPITAL
- **Authorized official:** LIZA J O'NEAL (C, PAD)
- **Authorized official phone:** (270) 798-8491

## Contact information

- **Practice address:** 647 DUNLOP LN, GATEWAY MEDICAL CENTER MEDICAL OFFICE BLDG ONE, CLARKSVILLE, TN 37040-5165
- **Practice address phone:** (270) 461-5019
- **Mailing address:** 650 JOEL DR, ATTN UBO, FORT CAMPBELL, KY 42223-5318
- **Mailing address phone:** (270) 798-8286

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM1100X | Military/U.S. Coast Guard Outpatient Clinic/Center | — | — | Yes |

## Other

- **Enumeration date:** 07/19/2010
- **Last updated:** 01/03/2013

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 1417044702 | PARENT BILLING NPI | — |