Provider Demographics
NPI:1861599623
Name:NAVAL HEALTH CLINIC BREMERTON
Entity type:Organization
Organization Name:NAVAL HEALTH CLINIC BREMERTON
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUMED UBO
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:M
Authorized Official - Last Name:CONDON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:240-401-3643
Mailing Address - Street 1:US NAVAL HOSPITAL BREMERTON WA C/O NAVAL HOSPITAL BREME
Mailing Address - Street 2:1 BOONE RD CODE 08RAZD
Mailing Address - City:BREMERTON
Mailing Address - State:WA
Mailing Address - Zip Code:98312-0000
Mailing Address - Country:US
Mailing Address - Phone:360-476-6872
Mailing Address - Fax:360-475-4676
Practice Address - Street 1:1400 FARRAGUT AVE # CODE063
Practice Address - Street 2:
Practice Address - City:BREMERTON
Practice Address - State:WA
Practice Address - Zip Code:98314
Practice Address - Country:US
Practice Address - Phone:360-476-6872
Practice Address - Fax:360-475-4786
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NAVAL HEALTH CLINIC BREMERTON
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-09-20
Last Update Date:2025-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332000000XSuppliersMilitary/U.S. Coast Guard Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2110637OtherPK