Organization
DEFENSE FINANCE & ACTG SERV
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TAJUDEEN OTTUN (ASSISTANT CHIEF PHARMACY)
(706) 544-0347
Entity
Organization
Contact information
Practice address
7950 MARTIN LOOP, FORT BENNING, GA 31905-5648
(706) 544-0347
Mailing address
5462 WHITTLESEY BLVD, APT# 927, COLUMBUS, GA 31909-2185
(850) 322-0680
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
RPH025911
GA
286500000X
Military Hospital
Primary
RPH025911
GA
Other
Enumeration date
07/24/2014
Last updated
07/24/2014
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