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Organization
MADIGAN ARMY MEDICAL CTR
Active
Organization
MADIGAN ARMY MEDICAL CTR
Active
Parent organization
MADIGAN ARMY MEDICAL CTR
Other names
OKUBO FAMILY PRACTICE CLINIC-FT LEWIS
Organization subpart
Yes
Provider details
NPI number
Legal business name
MADIGAN ARMY MEDICAL CTR
Authorized official
KAREN MADY (TPC MANAGER)
(253) 968-6598
Entity
Organization
Contact information
Practice address
BLDG 11582 17TH AND C STREET, NORTH FORT LEWIS, WA 98433
(253) 966-1991
Mailing address
9040A JACKSON AVE, ATTN: MCHJ-CSA-U, TACOMA, WA 98431-0001
(253) 968-6598
Taxonomy
Speciality
Code
Description
License number
State
261QM1100X
Military/U.S. Coast Guard Outpatient Clinic/Center
—
—
261QM1101X
Military and U.S. Coast Guard Ambulatory Procedure Clinic/Center
Primary
—
—
332000000X
Military/U.S. Coast Guard Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1841390077
PARENT FACILITY NPI
—
01
—
AN2598588
MEDCO
—
Enumeration date
05/14/2007
Last updated
04/13/2015
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