Provider Demographics
NPI:1194122564
Name:FORT BELVOIR COMMUNITY HOSPITAL
Entity type:Organization
Organization Name:FORT BELVOIR COMMUNITY HOSPITAL
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF DHA PASS
Authorized Official - Prefix:
Authorized Official - First Name:HECTOR
Authorized Official - Middle Name:
Authorized Official - Last Name:MORALES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-536-6650
Mailing Address - Street 1:FORT BELVOIR COMMUNITY HOSPITAL
Mailing Address - Street 2:9300 DEWITT LOOP
Mailing Address - City:FORT BELVOIR
Mailing Address - State:VA
Mailing Address - Zip Code:22060
Mailing Address - Country:US
Mailing Address - Phone:571-432-2790
Mailing Address - Fax:571-432-2796
Practice Address - Street 1:10580 ARROWHEAD DR
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22030-7301
Practice Address - Country:US
Practice Address - Phone:571-432-2790
Practice Address - Fax:571-432-2796
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-01
Last Update Date:2023-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332000000XSuppliersMilitary/U.S. Coast Guard Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2148927OtherPK