ATLANTIC CITY USCG PHCY (NPI# 1104011667) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104011667 |
| Entity Type | Organization |
| Organization Name | ATLANTIC CITY USCG PHCY |
| Practice Address |
Amelia Earhart Road Bldg 350 Atlantic City NJ 08405-0001 |
| Mailing Address |
2450 Stanley Rd Suite 208 Fort Sam Houston TX 78234-7510 |
| Practice Telephone | 6096772028 |
| Mailing Telephone | 2102218443 |
| Enumeration Date | 2007-09-07 |
| Last Update Date | 2007-09-07 |
| Authorized Official Name | MR. HECTOR MORALES (MANAGER DOD PHARMACY OPS) |
| Authorized Official Telephone | 2102218443 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332000000X | Military/U.S. Coast Guard Pharmacy | Suppliers |
| Street Address |
AMELIA EARHART ROAD BLDG 350 |
| City | ATLANTIC CITY |
| State | NJ |
| Zip Code | 08405-0001 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962660340 | United States Coast Guard, Air Station Atlantic City | Clinic/Center | Faa Tech Center Bldg 350, Uscg Medical Dept, Pomona, NJ 08405 | 2008-06-02 |
| 1144363383 | Hassan Kareem | Technician, Other | Us Cg Air Station Atlantic City, Faa Tech Center Bldg 350 (medical), Atlantic City, NJ 08405-0001 | 2007-02-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730780479 | Mae Lynne Tietje | Nurse Practitioner | 3830 Atlantic Ave, Atlantic City, NJ 08401-6080 | 2020-11-07 |
| 1275133175 | Kristy Liekfet | Nurse Practitioner | Atlanticare Apg Palliative Care, 1925 Pacific Ave. 1st Flr, Atlantic City, NJ 08401 | 2020-10-29 |
| 1295342459 | Keval Patel | Physician Assistant | 635 N Dover Ave, Atlantic City, NJ 08401-1021 | 2020-09-30 |
| 1558977827 | Andrey Rublev | Speech-Language Pathologist | 600 Atlantic Ave Apt 318, Atlantic City, NJ 08401-7506 | 2020-09-21 |
| 1366060550 | Zachary Sakena | Physician Assistant | 1925 Pacific Ave # 8, Atlantic City, NJ 08401-6713 | 2020-07-14 |
| 1407479462 | The Five Before Five Foundation, Inc. | Community/Behavioral Health | 1427 N Michigan Ave, Atlantic City, NJ 08401-1720 | 2020-05-26 |
| 1356991806 | Mmm Services | Community/Behavioral Health | 1829 Marmora Ave, Atlantic City, NJ 08401-2003 | 2019-09-17 |
| 1598319113 | Jerry Elton Walker Jr. | Specialist/Technologist | 1008 Absecon Blvd, Atlantic City, NJ 08401-2536 | 2019-07-31 |
| 1497317325 | Integrity Transit LLC | Non-emergency Medical Transport (VAN) | 130 N Florida Ave, Atlantic City, NJ 08401-3941 | 2019-07-01 |
| 1487117602 | Sreeja Sompalli | Student in an Organized Health Care Education/Training Program | 2015 Pacific Ave, Atlantic City, NJ 08401-6726 | 2019-04-14 |
| Find all providers in ATLANTIC CITY | ||||
| 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 |
|---|---|---|---|---|
| 1710287198 | Lakehurst | Military/U.S. Coast Guard Pharmacy | 39 Lansdown Road Bldg 39, Naval Air Engineering Station, Lakehurst, NJ 08733 | 2010-11-01 |
| 1346349792 | Naval Health Clinic Annapolis | Military/U.S. Coast Guard Pharmacy | Bmc Bldg 39, Naval Engineering Station, Lakehurst, NJ 08733 | 2006-09-22 |
| 1255430609 | 87th Medical Group | Military/U.S. Coast Guard Pharmacy | Naval Weapon Station Earl Hwy 35, Leonardo, NJ 07737 | 2006-09-22 |
| 1528167970 | Keller Army Community Hospital | Military/U.S. Coast Guard Pharmacy | 18th St and Doughboy Loop Bldg 5660, Troop Medical Health Clinic, Ft Dix, NJ 08640 | 2006-09-22 |
| 1164529913 | Us Coast Guard Finance Center | Military/U.S. Coast Guard Pharmacy | 1 Munro Ave Bldg 270, Cape May, NJ 08204-5000 | 2006-09-20 |
| 1255438008 | Colts Neck Phcy | Military/U.S. Coast Guard Pharmacy | 201 State Route 34 S Bldg C3, Naval Weapons Station Earle, Colts Neck, NJ 07722-1902 | 2006-09-20 |
| 1518150598 | Green Valley Medical Equipment | Military/U.S. Coast Guard Pharmacy | 214 E Main St, Bound Brook, NJ 08805-2026 | 2007-08-22 |
| 1194889865 | Keller Army Community Hospital | Military/U.S. Coast Guard Pharmacy | 1075 Stephenson Ave, Monmouth Poe Phcy, Fort Monmouth, NJ 07703-1518 | 2006-12-20 |
| 1437258886 | Keller Army Community Hospital | Military/U.S. Coast Guard Pharmacy | 1075 Stephenson Ave, Bldg 1075 Monmouth Op Phcy, Fort Monmouth, NJ 07703-1518 | 2006-09-22 |
| 1881650141 | 87 Medical Group | Military/U.S. Coast Guard Pharmacy | 3458 Neely Rd, Mdss Sgsbr, Mc Guire Afb, NJ 08641-5312 | 2006-04-25 |
| Find all providers with the same taxonomy | ||||
| City | ATLANTIC CITY |
| Zip Code | 08405 |
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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.