Organization
ACH BASSETT-WAINWRIGHT
Active
Parent organization
ACH BASSETT-WAINWRIGHT
Other names
ACH BASSETT-WAINWRIGHT
Organization subpart
Yes
Provider details
NPI number
Legal business name
ACH BASSETT-WAINWRIGHT
Authorized official
TYRA IVY (UBO MANAGER)
(907) 361-5948
Entity
Organization
Contact information
Practice address
1060 GAFFNEY RD # 7420, FT WAINWRIGHT, AK 99703-7420
(907) 361-5172
Mailing address
1060 GAFFNEY RD #7420, ATTN MCUC-PAD-TPC, FT WAINWRIGHT, AK 99703-7420
(907) 361-5948
(907) 361-4832
Taxonomy
Speciality
Code
Description
License number
State
261QM1100X
Military/U.S. Coast Guard Outpatient Clinic/Center
—
—
261QM1101X
Military and U.S. Coast Guard Ambulatory Procedure Clinic/Center
—
—
2865M2000X
Military General Acute Care Hospital
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0202351
PHARMACY NCPDP
—
01
—
AN2598588
MEDCO
—
Enumeration date
09/05/2006
Last updated
05/21/2025
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