87TH MEDICAL GROUP (NPI# 1255430609) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255430609 |
| Entity Type | Organization |
| Organization Name | 87TH MEDICAL GROUP |
| Other Organization Name | EARLE MAIN PHCY |
| Practice Address |
Naval Weapon Station Earl Hwy 35 Leonardo NJ 07737 |
| Mailing Address |
National Naval Medical Ctr Cdr Pius Aiyelawo 8901 Wisconsin Ave Bethesda MD 20889-0001 |
| Practice Telephone | 7578667180 |
| Practice Fax Number | 7578661116 |
| Mailing Telephone | 7578667180 |
| Mailing Fax Number | 7578661116 |
| Enumeration Date | 2006-09-22 |
| Last Update Date | 2015-06-18 |
| 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 | 2054885 | 01 |
| Other Name | Type Code |
|---|---|
| EARLE MAIN PHCY | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427465889 | 87th Medical Group | Pharmacy | 3458 Neely Rd, Joint Base Mdl, NJ 08641-5312 | 2014-07-17 |
| 1346347192 | 87th Medical Group | Pharmacy | 3458 Neely Rd, Joint Base Mdl, NJ 08641-5312 | 2006-09-20 |
| Street Address |
NAVAL WEAPON STATION EARL HWY 35 |
| City | LEONARDO |
| State | NJ |
| Zip Code | 07737 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629626130 | Daniel Louis Milford | Technician | 56 Hosford Avenue, Leonardo, NJ 07737 | 2019-08-28 |
| 1598277097 | Minding Miracles Learning Center | Behavioral Analyst | 45 Appleton Ave, 45 Appleton Ave, Leonardo, NJ 07737 | 2017-10-25 |
| 1760622500 | Alyssa Emily Cosentino | Speech-Language Pathologist | 950 Route 36, Leonardo, NJ 07737 | 2009-03-05 |
| 1174730402 | Rita Torres | Social Worker | Halcyon Eldercare, 102 Highland Ave, Leonardo, NJ 07737 | 2007-05-17 |
| 1306050612 | Louis Comanducci | Dentist | 942 Highway 36, Leonardo, NJ 07737 | 2007-05-09 |
| 1134693328 | Jaime Lyn Lavallo | Speech-Language Pathologist | 950 Route 36, Suite 100a, Leonardo, NJ 07737 | 2019-01-22 |
| 1467991471 | Patrick Rogers | Emergency Medicine | 40 Florence Ave, Leonardo, NJ 07737-1016 | 2017-02-23 |
| 1104256452 | Heart of Gold Ambulance Service, LLC | Non-emergency Medical Transport (VAN) | 50 Florence Ave, Leonardo, NJ 07737-1016 | 2013-11-23 |
| 1467812610 | Heather Dempsey | Massage Therapist | 445 Monmouth Ave, Leonardo, NJ 07737-1128 | 2016-03-01 |
| 1629405378 | Va Homecare LLC | Home Health | 394 Monmouth Ave, Leonardo, NJ 07737-1130 | 2013-09-26 |
| Find all providers in zip 07737 | ||||
| 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 |
| 1104011667 | Atlantic City Uscg Phcy | Military/U.S. Coast Guard Pharmacy | Amelia Earhart Road, Bldg 350, Atlantic City, NJ 08405-0001 | 2007-09-07 |
| 1346349792 | Naval Health Clinic Annapolis | Military/U.S. Coast Guard Pharmacy | Bmc Bldg 39, Naval Engineering Station, Lakehurst, NJ 08733 | 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 | ||||
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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.