REYNOLDS ARMY COMMUNITY HOSPITAL (NPI# 1023117066) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023117066 |
| Entity Type | Organization |
| Organization Name | REYNOLDS ARMY COMMUNITY HOSPITAL |
| Other Organization Name | PINE BLUFF ARSENAL PHCY |
| Practice Address |
10020 Kabrich Cir Pine Bluff AR 71602-9031 |
| Practice Telephone | 8705403413 |
| Practice Fax Number | 5804582445 |
| Mailing Telephone | 8705403413 |
| Mailing Fax Number | 5804582445 |
| Enumeration Date | 2006-09-22 |
| Last Update Date | 2016-01-13 |
| Authorized Official Name | HECTOR MORALES (CHIEF DHA PASS) |
| Authorized Official Telephone | 2105366650 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332000000X | Military/U.S. Coast Guard Pharmacy | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PK | 1989282 | 01 |
| Other Name | Type Code |
|---|---|
| PINE BLUFF ARSENAL PHCY | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912377649 | Reynolds Army Community Hospital | Clinic/Center | 3161 Hoskins Rd, Fort Sill, OK 73503-4462 | 2015-10-07 |
| 1740650464 | Reynolds Army Community Hospital | Clinic/Center | 3445 Koehler Loop, Fort Sill, OK 73503-6008 | 2015-10-07 |
| 1932480068 | Reynolds Army Community Hospital | Clinic/Center | 2640 Miner Rd, Fort Sill, OK 73503 | 2011-09-02 |
| 1457654766 | Reynolds Army Community Hospital | Military/U.S. Coast Guard Pharmacy | Custer Road, Bldg 2913, Fort Sill, OK 73503 | 2010-12-08 |
| 1427208008 | Reynolds Army Community Hospital | Clinic/Center | 2913 Craig Road, Fort Sill, OK 73503 | 2008-09-19 |
| 1760688220 | Reynolds Army Community Hospital | Clinic/Center | 2862 Craig Road, Fort Sill, OK 73503 | 2007-06-22 |
| 1881890358 | Reynolds Army Community Hospital | Clinic/Center | 605 Randolph Road, Fort Sill, OK 73503 | 2007-06-22 |
| 1699971143 | Reynolds Army Community Hospital | Clinic/Center | 6037 Bessinger Street, Fort Sill, OK 73503 | 2007-06-22 |
| 1831298017 | Reynolds Army Community Hospital | Military/U.S. Coast Guard Pharmacy | Macomb Rd Bldg 1719, Ft Sill, OK 73503 | 2006-09-22 |
| 1740389923 | Reynolds Army Community Hospital | Military/U.S. Coast Guard Pharmacy | Thomas Rd Bldg 6043 Tmc2, Ft Sill, OK 73503 | 2006-09-22 |
| Street Address |
10020 KABRICH CIR |
| City | PINE BLUFF |
| State | AR |
| Zip Code | 71602-9031 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174810394 | Patrick Depriest | Physician Assistant | 10020 Kabrich Cir, Pine Bluff, AR 71602-9031 | 2011-07-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265050447 | Bridget Furlong | Occupational Therapist | 2226 Barncy Lane, White Hall, AR 71602 | 2020-07-14 |
| 1609399963 | Interventional Surgery Institute of White Hall LLC | Clinic/Center | 7211 Dollarway Road, White Hall, AR 71602 | 2017-07-19 |
| 1679935761 | Pain Treatment Centers of America, Pllc | Durable Medical Equipment & Medical Supplies | 7211 Dollarway Rd, White Hall, AR 71602 | 2016-03-28 |
| 1326450446 | Rafeek Hegazy | Anesthesiology | 202 Frankie Ln, White Hall, AR 71602 | 2014-05-22 |
| 1275873515 | Craig Paul Anderson | Preventive Medicine | 13-020 Kabrich Circle, Pine Bluff, AR 71602 | 2013-02-24 |
| 1124258553 | Shellia Anne Kornegay | Nurse Practitioner | 1515 West 42nd Street, Pine Bluff, AR 71602 | 2009-07-20 |
| 1275789109 | Sarah Allison Rushing | Speech-Language Pathologist | 1020 West Holland Avenue, White Hall, AR 71602 | 2008-08-12 |
| 1245438852 | White Hall School District | Local Education Agency (LEA) | 1020 West Holland, White Hall, AR 71602 | 2007-07-05 |
| 1972622652 | Dewey Charles Scarbrough | Physician Assistant | 109 Frankie Lane, White Hall, AR 71602 | 2007-03-27 |
| 1427126135 | Donna D Massey | Dentist | 7215 Sheridan Road, White Hall, AR 71602 | 2006-12-01 |
| Find all providers in zip 71602 | ||||
| Taxonomy Code | 332000000X |
| Grouping | Suppliers |
| Classification | Military/U.S. Coast Guard Pharmacy |
| A Department of Defense (DoD) or U.S. Coast Guard entity whose primary function is to store, prepare and dispense pharmaceuticals and other associated items to Uniformed Services beneficiaries. These pharmacies may be associated with a DoD or U.S. Coast Guard clinic, DoD Hospital or freestanding. Usually associated with outpatient services. |
| Notes: Source: TRICARE Management Activity Uniform Business Office User’s Guide [1/1/2005: new; 7/1/2006: modified title, modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104989763 | 19th Mdss Sgsr | Military/U.S. Coast Guard Pharmacy | 1090 Arnold Dr Bldg 1090, Little Rock Afb, AR 72099-4933 | 2006-12-18 |
| 1932208972 | 19th Mdss Sgsr | Military/U.S. Coast Guard Pharmacy | 1090 Arnold Dr, Little Rock Afb, AR 72099-4933 | 2006-09-22 |
| 1841399888 | 19th Mdss Sgsr | Military/U.S. Coast Guard Pharmacy | 1090 Arnold Dr, Little Rock Afb, AR 72099-4933 | 2006-09-22 |
| 1073591830 | 19th Mdss Sgsr | Military/U.S. Coast Guard Pharmacy | 1090 Arnold Dr, Lr Afb, AR 72099-4933 | 2006-01-03 |
| City | PINE BLUFF |
| Zip Code | 71602 |
Please comment or provide details below to improve the information on REYNOLDS ARMY COMMUNITY HOSPITAL.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.