Organization
WOMACK ARMY MEDICAL CENTER
Active
Parent organization
WOMACK ARMY MEDICAL CENTER
Other names
TROOP & FAMILY MED CL-FT. BRAG
Organization subpart
Yes
Provider details
NPI number
Legal business name
WOMACK ARMY MEDICAL CENTER
Authorized official
BARBARA BLACK (UBO MANAGER)
(910) 907-8537
Entity
Organization
Contact information
Practice address
383 MAYNARD ST, POPE AFB, NC 28308-2321
(910) 907-9262
Mailing address
2817 REILLY ST, MCXC-DBO-UB WAMC STOP A, FORT BRAGG, NC 28310-7324
(910) 907-6693
Taxonomy
Speciality
Code
Description
License number
State
261QM1100X
Military/U.S. Coast Guard Outpatient Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00539
BCBS UB-04 PROVIDER ID
—
01
—
0294A
BCBS CMS 1500 PROVIDER ID
—
01
—
0465Y
BCBS PHARMACY ID
—
01
—
1740377423
PARENT NPI
—
Enumeration date
04/28/2010
Last updated
04/07/2014
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