Organization
BARQUIST ARMY HEALTH CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. PRASATHIP VONGXAY-SANO (STAFF PHARMACIST)
(301) 619-7175
Entity
Organization
Contact information
Practice address
1434 PORTER ST, FORT DETRICK, MD 21702-9254
(301) 619-7175
Mailing address
1434 PORTER ST, FORT DETRICK, MD 21702-9254
Taxonomy
Speciality
Code
Description
License number
State
261QC1500X
Community Health Clinic/Center
Primary
11850
NC
Other
Enumeration date
06/26/2015
Last updated
06/26/2015
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