Provider Demographics
NPI:1124261789
Name:US NAVAL HOSPITAL GUANTANAMO BAY
Entity type:Organization
Organization Name:US NAVAL HOSPITAL GUANTANAMO BAY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF MEDICAL SERVICES
Authorized Official - Prefix:DR
Authorized Official - First Name:TROY
Authorized Official - Middle Name:
Authorized Official - Last Name:BOREMA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:01159-997-2944
Mailing Address - Street 1:USNH GUANTANAMO BAY PRIMARY CARE
Mailing Address - Street 2:BOX 172 FPO AE
Mailing Address - City:FPO
Mailing Address - State:AE
Mailing Address - Zip Code:09589-1000
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:USNH GTMO BOX 172
Practice Address - Street 2:
Practice Address - City:FPO
Practice Address - State:AE
Practice Address - Zip Code:09589-1000
Practice Address - Country:US
Practice Address - Phone:01153-997-2944
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-13
Last Update Date:2009-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35078849286500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes286500000XHospitalsMilitary Hospital