Organization
BLANCHFIELD ARMY COMMUNITY HOSPITAL
Active
Parent organization
BLANCHFIELD ARMY COMMUNITY HOSPITAL
Other names
SCREAMING EAGLE MEDICAL HOME-CAMPB
Organization subpart
Yes
Provider details
NPI number
Legal business name
BLANCHFIELD ARMY COMMUNITY HOSPITAL
Authorized official
LIZA J O'NEAL (C, PAD)
(270) 798-8491
Entity
Organization
Contact information
Practice address
647 DUNLOP LN, GATEWAY MEDICAL CENTER MEDICAL OFFICE BLDG ONE, CLARKSVILLE, TN 37040-5165
(270) 461-5019
Mailing address
650 JOEL DR, ATTN UBO, FORT CAMPBELL, KY 42223-5318
(270) 798-8286
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
—
1417044702
PARENT BILLING NPI
—
Enumeration date
07/19/2010
Last updated
01/03/2013
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