NPIMap

Organization Active NPI

Meddac-Wach

  • Military Hospital
  • Fort Irwin, CA
National Provider Identifier
1720018757
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Military HospitalTaxonomy code 286500000X
License
PN5167255 Issued in FL
Legal business name
MEDDAC-WACH
Practice address
5092 Superior Valley CT # B
Fort Irwin, CA 92310-2046
Phone
(760) 386-8320
NPI assigned
Jul 4, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Maritsa Irby
Title
LPN
Phone
(760) 380-7343

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Military Hospital 286500000X PN5167255 FL Primary

Addresses

Primary practice location

5092 Superior Valley CT # B
Fort Irwin, CA 92310-2046

Mailing address

5092 Superior Valley CT # B
Fort Irwin, CA 92310-2046
Phone (760) 386-8320

National Provider Directory

National Provider Directory
Tax ID family
McDonald Army Health Care Center200 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 20

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 20

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1151971200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1720018757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5092 SUPERIOR VALLEY CT # B",
            "city": "FORT IRWIN",
            "state": "CA",
            "postal_code": "923102046",
            "telephone_number": "760-386-8320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5092 SUPERIOR VALLEY CT # B",
            "city": "FORT IRWIN",
            "state": "CA",
            "postal_code": "923102046",
            "telephone_number": "760-386-8320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDDAC-WACH",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-04",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "IRBY",
        "authorized_official_first_name": "MARITSA",
        "authorized_official_title_or_position": "LPN",
        "authorized_official_telephone_number": "760-380-7343"
    },
    "taxonomies": [
        {
            "code": "286500000X",
            "taxonomy_group": "",
            "desc": "Military Hospital",
            "state": "FL",
            "license": "PN5167255",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Irwin, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.