Provider Demographics
NPI:1215240908
Name:UNITED STATES NAVY
Entity type:Organization
Organization Name:UNITED STATES NAVY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:IDC
Authorized Official - Prefix:MR
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:ALLEN
Authorized Official - Last Name:LINEMAN
Authorized Official - Suffix:
Authorized Official - Credentials:CORPSMAN
Authorized Official - Phone:757-763-4059
Mailing Address - Street 1:2220 SCHOFIELD RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23459-8838
Mailing Address - Country:US
Mailing Address - Phone:757-763-4059
Mailing Address - Fax:757-492-1640
Practice Address - Street 1:2220 SCHOFIELD RD
Practice Address - Street 2:SUITE 200
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23459-8838
Practice Address - Country:US
Practice Address - Phone:757-763-4059
Practice Address - Fax:757-492-1640
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-22
Last Update Date:2010-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health