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Organization
CREECH AID STATION
Active
Organization
CREECH AID STATION
Active
Parent organization
MIKE O'CALLAGHAN FEDERAL HOSPITAL
Other names
99th Med Gp
Organization subpart
Yes
Provider details
NPI number
Legal business name
MIKE O'CALLAGHAN FEDERAL HOSPITAL
Authorized official
MR. CHRISTOPHER DOUGLAS EATON (UNIFORM BUSINESS OFFICE PROGRAM MGR)
(703) 681-6303
Entity
Organization
Contact information
Practice address
2D STREET BLDG #54, INDIAN SPRINGS, NV 89018
(702) 404-1142
Mailing address
4700 LAS VEGAS BLVD N, NELLIS AFB, NV 89191-6600
(702) 653-2015
Taxonomy
Speciality
Code
Description
License number
State
261QM1100X
Military/U.S. Coast Guard Outpatient Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2975742
NCPDP
NV
Enumeration date
07/06/2009
Last updated
07/06/2009
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