# BARQUIST ARMY HEALTH CLINIC

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

## Provider details

- **NPI number:** 1821470774
- **Authorized official:** MRS. PRASATHIP VONGXAY-SANO (STAFF PHARMACIST)
- **Authorized official phone:** (301) 619-7175

## Contact information

- **Practice address:** 1434 PORTER ST, FORT DETRICK, MD 21702-9254
- **Practice address phone:** (301) 619-7175
- **Mailing address:** 1434 PORTER ST, FORT DETRICK, MD 21702-9254

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QC1500X | Community Health Clinic/Center | 11850 | NC | Yes |

## Other

- **Enumeration date:** 06/26/2015
- **Last updated:** 06/26/2015