Organization
WEED ARMY COMMUNITY HOSPITAL
Active
Parent organization
WEED ARMY COMMUNITY HOSPITAL
Other names
TBI CLINIC-IRWIN
Organization subpart
Yes
Provider details
NPI number
Legal business name
WEED ARMY COMMUNITY HOSPITAL
Authorized official
DERRECK SUMMERS (C, PAD)
(760) 380-3392
Entity
Organization
Contact information
Practice address
BLDG 189 AVE B, FORT IRWIN, CA 92310
(760) 380-7473
Mailing address
4TH STREET, BLDG 166 RM 109, FORT IRWIN, CA 92310-5109
(760) 380-5213
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
—
1275618514
PARENT FACILITY WACH NPI 2
—
Enumeration date
06/18/2014
Last updated
04/07/2015
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