MONCRIEF ARMY COMMUNITY HOSPITAL (NPI# 1043319213) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1043319213 |
Entity Type | Organization |
Organization Name | MONCRIEF ARMY COMMUNITY HOSPITAL |
Other Organization Name | JACKSON TMC PHCY |
Practice Address |
Bldg 4575 Marion Ave Ft Jackson SC 29207 |
Practice Telephone | 8037517358 |
Practice Fax Number | 8037512451 |
Mailing Telephone | 8037517358 |
Mailing Fax Number | 8037512451 |
Enumeration Date | 2006-09-22 |
Last Update Date | 2016-01-26 |
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 | 2091733 | 01 |
Other Name | Type Code |
---|---|
JACKSON TMC PHCY | Doing Business As Name - Organization |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1669877064 | Moncrief Army Community Hospital | Military/U.S. Coast Guard Pharmacy | 1021 Pinnacle Point Dr Ste 200, Columbia, SC 29223-5740 | 2014-10-28 |
1972823722 | Moncrief Army Community Hospital | Clinic/Center | 1021 Pinnancle Point, Moncrief Medical Home-jackson, Columbia, SC 29223-5740 | 2010-06-03 |
1376749838 | Moncrief Army Community Hospital | Clinic/Center | 5330 Mosby Street, Fort Jackson, SC 29207 | 2007-06-22 |
1902002462 | Moncrief Army Community Hospital | Clinic/Center | 1890 Washington Road, Fort Jackson, SC 29207 | 2007-06-22 |
1932304946 | Moncrief Army Community Hospital | Clinic/Center | 4590 Strom Thurmond Blvd, Columbia, SC 29207-5305 | 2007-06-19 |
1235238411 | Moncrief Army Community Hospital | Military/U.S. Coast Guard Pharmacy | Bldg 4500, Stuart Street, Ft Jackson, SC 29207 | 2006-09-22 |
1881793057 | Moncrief Army Community Hospital | Military/U.S. Coast Guard Pharmacy | Bldg 4716, Commissary Rd, Ft Jackson, SC 29207 | 2006-09-22 |
1194138859 | Moncrief Army Community Hospital | Pharmacy | 4500 Stuart Ave, Columbia, SC 29207-5700 | 2014-06-10 |
1316228448 | Moncrief Army Community Hospital | Clinic/Center | 4323 Hill St, Columbia, SC 29207-6022 | 2011-09-02 |
1073802807 | Moncrief Army Community Hospital | Military/U.S. Coast Guard Pharmacy | 4500 Stuart Ave, Columbia, SC 29207-5700 | 2011-04-01 |
Street Address |
BLDG 4575 MARION AVE |
City | FT JACKSON |
State | SC |
Zip Code | 29207 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1265043756 | Steven Mariani Rodriguez | Dentist | 5330 Moseby Street, Columbia, SC 29207 | 2020-08-10 |
1568082493 | Nichole Eckrich | Dentist | 5330 Moseby St., Columbia, SC 29207 | 2020-04-21 |
1730733007 | Forrest Wane Fullenkamp | Student in an Organized Health Care Education/Training Program | 5330 Moseby St, Columbia, SC 29207 | 2019-07-25 |
1306401625 | Kayla Anne Wolcott | Pharmacist | Moncrief Army Hospital Outpatient Pharmacy 1 Ft Jackson, Columbia, SC 29207 | 2019-05-02 |
1588145098 | Renetta Denise Green | Counselor | Fort Jackson/acs 9810 Lee St, Columbia, SC 29207 | 2018-08-23 |
1154814028 | Amanda Zelnick | Dentist | Bldg 5330 Moseby St, Ft Jackson, NC 29207 | 2018-06-14 |
1790231777 | Brittaney Elizabeth Anne Lewelling | Specialist/Technologist | 5975 Chesnut Road, Columbia, SC 29207 | 2016-08-30 |
1376749838 | Moncrief Army Community Hospital | Clinic/Center | 5330 Mosby Street, Fort Jackson, SC 29207 | 2007-06-22 |
1902002462 | Moncrief Army Community Hospital | Clinic/Center | 1890 Washington Road, Fort Jackson, SC 29207 | 2007-06-22 |
1730279860 | Donna L Briquet | Pharmacist | 4500 Marion Street, Columbia, SC 29207 | 2006-10-12 |
Find all providers in zip 29207 |
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 |
---|---|---|---|---|
1235238411 | Moncrief Army Community Hospital | Military/U.S. Coast Guard Pharmacy | Bldg 4500, Stuart Street, Ft Jackson, SC 29207 | 2006-09-22 |
1881793057 | Moncrief Army Community Hospital | Military/U.S. Coast Guard Pharmacy | Bldg 4716, Commissary Rd, Ft Jackson, SC 29207 | 2006-09-22 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1669877064 | Moncrief Army Community Hospital | Military/U.S. Coast Guard Pharmacy | 1021 Pinnacle Point Dr Ste 200, Columbia, SC 29223-5740 | 2014-10-28 |
1114332368 | 628 Medical Group | Military/U.S. Coast Guard Pharmacy | 204 W Hill Blvd Bldg 364, Charleston Afb, SC 29404-4704 | 2014-06-26 |
1306945563 | Naval Hospital Beaufort | Military/U.S. Coast Guard Pharmacy | Bldg 669, Parris Island, SC 29905 | 2006-09-22 |
1760581946 | 20th Medical Group Sgsl | Military/U.S. Coast Guard Pharmacy | 515 Exchange St, Bldg 1448, Shaw Afb, SC 29152-5033 | 2006-09-22 |
1881009033 | 20th Medical Support Squadron | Military/U.S. Coast Guard Pharmacy | 431 Meadowlark St, Shaw Afb, SC 29152-5019 | 2014-06-26 |
1811309339 | Naval Hospital Beaufort | Military/U.S. Coast Guard Pharmacy | 1 Pinckney Blvd, Naval Hospital Beaufort, Beaufort, SC 29902 | 2014-06-02 |
1073802807 | Moncrief Army Community Hospital | Military/U.S. Coast Guard Pharmacy | 4500 Stuart Ave, Columbia, SC 29207-5700 | 2011-04-01 |
1972602134 | 628 Medical Group | Military/U.S. Coast Guard Pharmacy | 204 W Hill Blvd, Charleston Afb, SC 29404-4704 | 2006-09-22 |
1881793040 | Naval Hospital Beaufort | Military/U.S. Coast Guard Pharmacy | 1 Pinckney Blvd, Bldg 1, Beaufort, SC 29902 | 2006-09-22 |
1215036470 | Naval Hospital Beaufort | Military/U.S. Coast Guard Pharmacy | Bldg 598, Beaufort, SC 29902 | 2006-09-22 |
Find all providers with the same taxonomy |
City | FT JACKSON |
Zip Code | 29207 |
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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.