# WACH

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

## Provider details

- **NPI number:** 1629474085
- **Authorized official:** TAMI RENE RIDER (SONOGRAPHER)
- **Authorized official phone:** (912) 332-4787

## Contact information

- **Practice address:** 200 CARLIE CT, HINESVILLE, GA 31313-3810
- **Practice address phone:** (912) 332-4787
- **Mailing address:** 200 CARLIE CT, HINESVILLE, GA 31313-3810
- **Mailing address phone:** (912) 332-4787

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 286500000X | Military Hospital | — | NULL | Yes |

## Other

- **Enumeration date:** 11/13/2014
- **Last updated:** 11/13/2014