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Organization

KENNER ARMY HEALTH CLINIC

Active
Parent organization
KENNER ARMY HEALTH CLINIC
Other names
TMC-1 Kenner-Ft Lee
Organization subpart
Yes

Provider details

NPI number
Legal business name
KENNER ARMY HEALTH CLINIC
Authorized official
CARLOS RODRIGUEZ-ROSADO (NCOIC PAD)
(804) 734-9299
Entity
Organization

Contact information

Practice address
700 24TH ST, BLDG 3219 NCXO TMC, FORT LEE, VA 23801-1716
(804) 734-9000
Mailing address
700 24TH ST, ATTN PAD, FORT LEE, VA 23801-1716
(804) 734-9306

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
1891854014
PARENT FACILITY NPI 2
Enumeration date
09/02/2011
Last updated
01/30/2014
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