?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.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Military Outpatient Operational (Transportable) Component |
261QM1102X |
| NPI Number | 1255519740 |
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| LBN Legal business name | LYSTER ARMY HEALTH CLINIC | ||||
| Authorized official | CAROLYN BOOZER - (RN) | ||||
| Entity | Organization | ||||
| Organization subpart 1 | No | ||||
| Enumeration date | 02/06/2008 | ||||
| Last updated | 02/06/2008 - About 18 years ago | ||||
| Identifiers |
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