MONCRIEF ARMY COMMUNITY HOSPITAL


Address: 4500 Stuart Ave, Columbia, SC 29207-5700
Phone: 8034193830

MONCRIEF ARMY COMMUNITY HOSPITAL (NPI# 1194138859) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1194138859
Entity Type Organization
Organization Name MONCRIEF ARMY COMMUNITY HOSPITAL
Other Organization Name DOD FT JACKSON EPHCY
Practice Address 4500 Stuart Ave
Columbia
SC 29207-5700
Mailing Address Moncrief Army Community Hospital
4500 Stuart St Box 497
Fort Jackson
SC 29207-5700
Practice Telephone 8034193830
Practice Fax Number 8034193845
Mailing Telephone 8037512415
Mailing Fax Number 8037512048
Enumeration Date 2014-06-10
Last Update Date 2017-02-27
Authorized Official Name HECTOR MORALES (CHIEF DHA PASS)
Authorized Official Telephone 2105366650
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 333600000X Pharmacy Suppliers
Y 332000000X Military/U.S. Coast Guard Pharmacy Suppliers

Other Provider Identifier

State Issuer Identifier Type Code
PK 2146206 01

Other Provider/Organization Names

Other Name Type Code
DoD FT JACKSON ePhcy Doing Business As Name - Organization

Other Provider IDs and Locations

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
1043319213 Moncrief Army Community Hospital Military/U.S. Coast Guard Pharmacy Bldg 4575, Marion Ave, 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
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

Office Location

Street Address 4500 STUART AVE
City COLUMBIA
State SC
Zip Code 29207-5700

Providers in the same location

NPI Name Taxonomy Address Enumeration
1700843745 Marjorie Arlene Burniston Occupational Therapist 4500 Stuart Ave, Mach-occupational Therapy, Columbia, SC 29207-5700 2006-04-26
1396193348 Athena Freeman Nurse Practitioner 4500 Stuart Ave, Columbia, SC 29207-5700 2016-06-01
1780086561 Scott Richardson Registered Nurse 4500 Stuart Ave, Columbia, SC 29207 2014-09-23
1073802807 Moncrief Army Community Hospital Military/U.S. Coast Guard Pharmacy 4500 Stuart Ave, Columbia, SC 29207-5700 2011-04-01
1720235484 Crystal Lloyd Brigantti Optometrist 4500 Stuart Ave, Columbia, SC 29207-5700 2008-08-25

Providers in the same zip code

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 Information

Taxonomy Code 332000000X
Grouping Suppliers
Classification Military/U.S. Coast Guard Pharmacy

Taxonomy Definition

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]

Providers in the same taxonomy and city

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
1073802807 Moncrief Army Community Hospital Military/U.S. Coast Guard Pharmacy 4500 Stuart Ave, Columbia, SC 29207-5700 2011-04-01

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
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
1235238411 Moncrief Army Community Hospital Military/U.S. Coast Guard Pharmacy Bldg 4500, Stuart Street, Ft Jackson, SC 29207 2006-09-22
1043319213 Moncrief Army Community Hospital Military/U.S. Coast Guard Pharmacy Bldg 4575, Marion Ave, 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
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
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
Find all providers with the same taxonomy

Competitor

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City COLUMBIA
Zip Code 29207

Improve Information

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Dataset Information

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.

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