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Organization

FT RUCKER EMS

Active
Parent organization
LYSTER ARMY HEALTH CLINIC
Organization subpart
Yes

Provider details

NPI number
Legal business name
LYSTER ARMY HEALTH CLINIC
Authorized official
MR. DAVID N HATAWAY PARAMEDIC (CHIEF EMS)
(334) 255-7032
Entity
Organization

Contact information

Practice address
BLDG 301 ANDREWS AVE, FT RUCKER, AL 36362-5333
(334) 255-7032
Mailing address
BLDG 301 ANDREWS AVE, FT RUCKER, AL 36362-5333
(334) 255-7032

Taxonomy

Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
9142973
AL

Other

Enumeration date
07/01/2008
Last updated
07/01/2008
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