Organization
WOMACK ARMY MEDICAL CENTER
Active
Parent organization
WOMACK ARMY MEDICAL CENTER
Other names
CLARK CLINIC
Organization subpart
Yes
Provider details
NPI number
Legal business name
WOMACK ARMY MEDICAL CENTER
Authorized official
BARBARA BLACK (UBO MANAGER)
(910) 907-8537
Entity
Organization
Contact information
Practice address
44 BASTOGNE DR, FORT BRAGG, NC 28310-0001
(910) 907-9262
Mailing address
2817 REILLY ST, MCXC-DBO-UB WAMC STOP A, FORT BRAGG, NC 28310-7324
(910) 907-6693
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
—
00539
BCBS UB-04 PROVIDER ID
—
01
—
0294A
BCBS CMS 1500 PROVIDER ID
—
01
—
0465Y
BCBS PHARMACY ID
—
01
—
1740377423
PARENT FACILITY NPI
—
Enumeration date
05/15/2007
Last updated
02/11/2013
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