Organization
ALEXANDER T AUGUSTA MED CTR-FT BELVOIR
Active
Parent organization
ALEXANDER T AUGUSTA MED CTR-FT BELVOIR
Other names
DILORENZO TRICARE HEALTH CLINIC
Organization subpart
Yes
Provider details
NPI number
Legal business name
ALEXANDER T AUGUSTA MED CTR-FT BELVOIR
Authorized official
WILLIAM MICHAEL CONDON (DHA UBO)
(240) 401-3643
Entity
Organization
Contact information
Practice address
THE PENTAGON, WASHINGTON, DC 20310-5600
(301) 295-4934
Mailing address
8901 WISCONSIN AVE, PSC BOX 509 CODE 6300, BETHESDA, MD 20889-5600
Taxonomy
Speciality
Code
Description
License number
State
261QM1100X
Military/U.S. Coast Guard Outpatient Clinic/Center
Primary
—
—
332000000X
Military/U.S. Coast Guard Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0904119
PHARMACY NCPDP
—
01
—
1063441905
PARENT FACILITY NPI UNTIL 30 AUG 2011
—
01
—
1639130222
PARENT FACILITY NPI EFFECTIVE 1 SEP 2011
—
Enumeration date
05/10/2007
Last updated
05/30/2025
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