Provider Demographics
NPI:1306919501
Name:WEED ARMY COMMUNITY HOSPITAL
Entity type:Organization
Organization Name:WEED ARMY COMMUNITY HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RN
Authorized Official - Prefix:MRS
Authorized Official - First Name:BRENDA
Authorized Official - Middle Name:JEANNETTE
Authorized Official - Last Name:STOCKHILL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:760-380-5183
Mailing Address - Street 1:26591 CUMBERLAND LANE
Mailing Address - Street 2:PO BOX 3626
Mailing Address - City:HELANDALE
Mailing Address - State:CA
Mailing Address - Zip Code:92342
Mailing Address - Country:US
Mailing Address - Phone:760-243-3276
Mailing Address - Fax:
Practice Address - Street 1:INNER LOOP
Practice Address - Street 2:
Practice Address - City:FORT IRWIN
Practice Address - State:CA
Practice Address - Zip Code:92310-5109
Practice Address - Country:US
Practice Address - Phone:760-380-5183
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN21173722865M2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2865M2000XHospitalsMilitary HospitalMilitary General Acute Care Hospital