# USCG RALPH NIX MEDICAL

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

## Provider details

- **NPI number:** 1285759712
- **Authorized official:** BRANDELLE MARIE DELPH EMT-B (HEALTH SERVICES TECHNICIAN)
- **Authorized official phone:** (707) 765-7702

## Contact information

- **Practice address:** USCG HQ COMDT (CG-1122), 2100 SECOND STREET SOUTH WEST, WASHINGTON, DC 20593-0001
- **Practice address phone:** (202) 475-5181
- **Practice address fax:** (202) 475-5909
- **Mailing address:** USCG HQ COMDT (CG-1122), 2100 SECOND STREET SOUTH WEST, WASHINGTON, DC 20593-0001
- **Mailing address phone:** (202) 475-5181
- **Mailing address fax:** (202) 475-5909

## Taxonomy

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

## Other

- **Enumeration date:** 03/21/2007
- **Last updated:** 11/14/2007