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LAWRENCE JOEL ARMY HEALTH CLINIC NPI 1265516470


NPI Information

NPI: 1265516470
Provider Name: LAWRENCE JOEL ARMY HEALTH CLINIC
Classification: Clinic/Center - 261QM1102X
Entity Type: Organization

Specialization: Military Outpatient Operational (Transportable) Component

Address:
1701 HARDEE AVE
FT MCPHERSON, GA
ZIP 30330
Phone: (404) 464-0304
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LAWRENCE JOEL ARMY HEALTH CLINIC is a military outpatient operational (transportable) component clinic center in Ft Mcpherson, GA. The provider is non-fixed facilities or distinct parts of a non-fixed facility, providing outpatient medical and dental services, primarily intended for DoD active duty. The entity is funded with other than Defense Health Program funding. Non-DoD active duty may receive services from this entity. Non-fixed facilities are generally deployed DoD health care activities, not providing services on or in association with a DoD fort or base. Non-fixed facilities include outpatient services furnished onboard ships. Non-fixed facilities also include deployed clinics. Does not include items issued directly to a patient from an outpatient pharmacy or patient transport. LAWRENCE JOEL ARMY HEALTH CLINIC NPI is 1265516470. The provider is registered as an organization entity type.

The provider's business location address is:

1701 HARDEE AVE
FT MCPHERSON, GA
ZIP 30330
Phone: (404) 464-0304
Fax: (404) 464-0303

The provider's authorized official is Carmen Rakestraw Agnew .
The authorized official title is Staff Pharmacist and has the following contact phone number (404) 464-0304.

The enumeration date for this NPI number is 10/24/2006 and was last updated on 8/22/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QM1102XClinic/CenterMilitary Outpatient Operational (Transportable) Component11620GEORGIAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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