KELLER ARMY COMMUNITY HOSPITAL (NPI# 1225243181) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1225243181 |
| Entity Type | Organization |
| Organization Name | KELLER ARMY COMMUNITY HOSPITAL |
| Other Organization Name | USAOHC TOBYHANNA ARMY DEPOT |
| Practice Address |
11 Hap Arnold Blvd Tobyhanna PA 18466-5002 |
| Mailing Address |
900 Washington Rd Attn: Mcud-rmd-ubo West Point NY 10996-1109 |
| Practice Telephone | 8005522907 |
| Mailing Telephone | 8459388239 |
| Enumeration Date | 2007-05-14 |
| Last Update Date | 2012-12-20 |
| Authorized Official Name | KENNETH TUFFY (UBO MANAGER) |
| Authorized Official Telephone | 8459388239 |
| Is Organization Subpart | Y |
| Parent Organization Name | KELLER ARMY COMMUNITY HOSPITAL |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM1100X |
Clinic/Center Specialization: Military/U.S. Coast Guard Outpatient |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PARENT FACILITY NPI | 1528161916 | 01 |
| Other Name | Type Code |
|---|---|
| USAOHC TOBYHANNA ARMY DEPOT | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235334392 | Keller Army Community Hospital | Clinic/Center | 606 Cullum Road, Building 606, West Point, NY 10996 | 2007-06-19 |
| 1275747149 | Keller Army Community Hospital | Clinic/Center | 5631 Baltimore St, Fort Dix, NJ 08640-5440 | 2007-05-10 |
| 1174622542 | Keller Army Community Hospital | Pharmacy | Bldg 606, West Point, NY 10996 | 2006-09-22 |
| 1427157882 | Keller Army Community Hospital | Pharmacy | Bldg 900, West Point, NY 10996 | 2006-09-22 |
| 1912006362 | Keller Army Community Hospital | Military/U.S. Coast Guard Pharmacy | Bldg 114 Rm 175, Ft Hamilton, NY 11252 | 2006-09-22 |
| 1588763841 | Keller Army Community Hospital | Military/U.S. Coast Guard Pharmacy | 11 Hap Amold Blvd, Tobyhanna, PA 18466 | 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 |
| 1912006685 | Keller Army Community Hospital | Clinic/Center | Bldg. 1075 Stephenson Ave., Ft. Monmouth, NJ 07703 | 2006-09-21 |
| 1861469355 | Keller Army Community Hospital | Rehabilitation Unit | 11 Hap Arnold Blvd, Health Clinic, Tobyhanna, PA 18466-5002 | 2006-03-02 |
| 1861898942 | Keller Army Community Hospital | Military/U.S. Coast Guard Pharmacy | 114 White Ave, Brooklyn, NY 11252-9503 | 2014-11-17 |
| Street Address |
11 HAP ARNOLD BLVD |
| City | TOBYHANNA |
| State | PA |
| Zip Code | 18466-5002 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861469355 | Keller Army Community Hospital | Rehabilitation Unit | 11 Hap Arnold Blvd, Health Clinic, Tobyhanna, PA 18466-5002 | 2006-03-02 |
| 1497789994 | Richard Lippin | Preventive Medicine | 11 Hap Arnold Blvd, Occupational Health Clinic-tobyhanna Army Depot, Tobyhanna, PA 18466-5002 | 2006-07-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932718061 | Katelyn Mckillop | Physician Assistant | 5074 Seneca Way, Tobyhanna, PA 18466 | 2020-07-24 |
| 1508330663 | Devereux Foundation | Day Training, Developmentally Disabled Services | 11 Carriage Square, Tobyhanna, PA 18466 | 2019-01-11 |
| 1144743873 | Luisa Tieso | Psychologist | 6167 Somers Terr, Tobyhanna, PA 18466 | 2017-07-25 |
| 1982087797 | Patricia Detrick | Physical Therapy Assistant | 100 Communtiy Drive, Suite 105, Tobyhanna, PA 18466 | 2015-06-30 |
| 1376959569 | Mountain Valley Orthopedics PC | Pharmacy | 100 Community Drive Stuite 210, Tobyhanna, PA 18466 | 2014-07-08 |
| 1346674975 | Michelle Backus | Social Worker | 633 Lakeside Drive, Tobyhanna, PA 18466 | 2013-08-30 |
| 1205107067 | Sharon and Cynthia | Home Health | 9249 Westwood Dr, Tobyhanna, PA 18466 | 2012-01-25 |
| 1689942260 | Family Care Centers, Inc. | Internal Medicine | 100 Community Drive, Suite 102, Tobyhanna, PA 18466 | 2011-12-09 |
| 1942599063 | Diane Latosek | Pharmacist | 12 Carriage Square, Tobyhanna, PA 18466 | 2011-03-29 |
| 1588763841 | Keller Army Community Hospital | Military/U.S. Coast Guard Pharmacy | 11 Hap Amold Blvd, Tobyhanna, PA 18466 | 2006-09-22 |
| Find all providers in zip 18466 | ||||
| Taxonomy Code | 261QM1100X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Military/U.S. Coast Guard Outpatient |
| The Defense Health Program or U.S. Coast Guard funded "fixed" facilities or distinct parts of a facility, providing outpatient medical and dental services, primarily for Uniformed Services beneficiaries. A "fixed" facility is a non-temporary, non-deployed facility. It includes mobile specialty units such as Magnetic Resonance Imaging (MRI) units that may furnish services at the "fixed" facility. It includes, as examples, the institutional portion of outpatient encounters (except Ambulatory Procedure Visits), supplies issued (e.g., glasses, ostomy supplies, crutches), and radiology and laboratory studies. Does not include items issued directly to a patient from an outpatient pharmacy or patient transport. |
| Notes: Source: TRICARE Management Activity Uniform Business Office User’s Guide [1/1/2005: title modified, definition added; 7/1/2006 title modified, definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609381623 | Branch Medical Clinic Philadelphia | Clinic/Center | 4898 S Broad St, Philadelphia, PA 19112-1320 | 2017-12-13 |
| 1871709576 | Kimbrough Acc Military Mtf | Clinic/Center | 99 G Street, Bldg 400, New Cumberland, PA 17070 | 2007-05-16 |
| 1417163114 | Kimbrough Acc Military Mtf | Clinic/Center | 1999 Fisher Ave, Fort Indiantown Gap, Annville, PA 17003 | 2007-05-16 |
| 1235345935 | Kimbrough Acc Military Mtf | Clinic/Center | Letterkenny Army Depot, Bldg 332, Chambersburg, PA 17201 | 2007-05-16 |
| 1215134747 | Branch Medical Clinic Mechanicsburg | Clinic/Center | 5450 Carlisle Pike, Bldg 23a, Mechanicsburg, PA 17050-2411 | 2007-06-28 |
| 1174728414 | Kimbrough Acc Military Mtf | Clinic/Center | 450 Gibner Rd, Usadc, Carlisle Barracks, PA 17013-5003 | 2007-06-18 |
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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.