LYSTER ARMY HEALTH CLINIC (NPI# 1255519740) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255519740 |
| Entity Type | Organization |
| Organization Name | LYSTER ARMY HEALTH CLINIC |
| Practice Address |
Andrews Ave Building 301 Ft Rucker AL 36362 |
| Mailing Address |
Andrews Avenue Bldg 301 Ft Rucker AL 36362 |
| Practice Telephone | 3342557033 |
| Mailing Telephone | 3342557033 |
| Enumeration Date | 2008-02-06 |
| Last Update Date | 2008-02-06 |
| Authorized Official Name | CAROLYN ANN BOOZER (RN) |
| Authorized Official Telephone | 3342557033 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM1102X |
Clinic/Center Specialization: Military Outpatient Operational (Transportable) Component |
1-044039 | AL | Ambulatory Health Care Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174774863 | Lyster Army Health Clinic | Military Hospital | 301dustoff Ave, Lyster Army Health Clinic, Fort Rucker, AL 36362-5333 | 2008-10-01 |
| 1447407218 | Lyster Army Health Clinic | Military Hospital | Building 301, Andrews Ave, Lyster Army Health Clinic, Fpo, AE 36362-5333 | 2008-08-25 |
| 1093978454 | Lyster Army Health Clinic | Military Hospital | Buliding 301 Andrews Ave, Lyster Army Health Clinic, Fpo, AA 36362-5333 | 2008-07-07 |
| 1366610115 | Lyster Army Health Clinic | Clinic/Center | Dept of Primary Care&community Med, Fort Rucker, AL 36362 | 2008-02-14 |
| 1366610123 | Lyster Army Health Clinic | Clinic/Center | Lyster Army Health Clinic Bldg. 301, Ft. Rucker, AL 36362 | 2008-02-14 |
| 1821410242 | Lyster Army Health Clinic | Clinic/Center | Lyster Army Health Clinic, Building 301 Andrews Avenue, Fort Rucker, AL 36362-5333 | 2014-01-21 |
| 1033532486 | Lyster Army Health Clinic | Clinic/Center | 301 Andrews Avenue, Lyster Army Health Clinic, Fort Rucker, AL 36362-5333 | 2014-01-21 |
| 1093029027 | Lyster Army Health Clinic | Clinic/Center | Lyster Army Health Clinic, Bldg 301 Andrews Avenue, Fort Rucker, AL 36362-5333 | 2010-08-02 |
| 1568612497 | Lyster Army Health Clinic | Military Hospital | Bldg 301, Andrews Ave, Lyster Army Health Clinic, Fpo, AE 36362-5333 | 2008-09-29 |
| 1316197452 | Lyster Army Health Clinic | Military Hospital | Andrews Ave, Bldg 301, Lyster Army Health Clinic, Fort Rucker, AL 36362 | 2008-09-25 |
| Street Address |
ANDREWS AVE BUILDING 301 |
| City | FT RUCKER |
| State | AL |
| Zip Code | 36362 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134381072 | Cindy L Carlen | Emergency Medical Technician, Paramedic | Andrews Ave, Bldg 301, Ft Rucker, AL 36362-5333 | 2008-07-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235745571 | Rachel Kestler | Specialist | 4102 Gadiator Street, Fort Rucker, AL 36362 | 2020-09-22 |
| 1417589268 | Jacob Michael Lezon | Emergency Medical Technician, Basic | 30501 Nevins St., Ft. Rucker, AL 36362 | 2020-02-10 |
| 1225535388 | Rhonda Lewis Wesolek | Dental Hygienist | Bldg 4405, Innkeeper Street, Fort Rucker, AL 36362 | 2018-04-06 |
| 1770013369 | National Vision, Inc. | Technician/Technologist | Bldg 9214, Fort Rucker, AL 36362 | 2017-06-15 |
| 1750730958 | Teresa Morgan Knighten | Dental Hygienist | 4405 Innkeepers St, Fort Rucker, AL 36362 | 2016-06-08 |
| 1568826246 | David Virgil II | Technician, Other | 2218 6th Avenue Building 4102, Fort Rucker, AL 36362 | 2016-04-08 |
| 1356771257 | Robert E Smith | Emergency Medical Technician, Intermediate | Blding 301 Andrew Ave, Ft Rucker, AL 36362 | 2013-11-14 |
| 1548503469 | Lindsey Taylor Mendenhall | Emergency Medical Technician, Basic | Bldg 301 Andrews Ave 1-223rd Hhc, Lyster Army Health Clinic, Fort Rucker, AL 36362 | 2013-03-28 |
| 1689913808 | Sunland Optical Co., Inc. | Eyewear Supplier (Equipment, not the service) | Fort Rucker Bldg. 9214, Daleville, AL 36362 | 2013-02-07 |
| 1275880205 | Sandra Lynn Griffin Banner | Optometrist | 33 Endl Ave, Fort Rucker, AL 36362 | 2012-08-09 |
| Find all providers in zip 36362 | ||||
| Taxonomy Code | 261QM1102X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Military Outpatient Operational (Transportable) Component |
| "Non-fixed" facilities or distinct parts of a "non-fixed" facility, providing outpatient medical and dental services, primarily intended for DoD active duty. The entity is funded with other than Defense Health Program funding. Non-DoD active duty may receive services from this entity. "Non-fixed" facilities are generally deployed DoD health care activities, not providing services on or in association with a DoD fort or base. "Non-fixed" facilities include outpatient services furnished onboard ships. "Non-fixed" facilities also include deployed clinics. Does not include items issued directly to a patient from an outpatient pharmacy or patient transport. |
| Notes: [1/1/2005: title modified, definition added] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326320144 | United States Army | Clinic/Center | 301 Andrews Avenue, Fort Rucker, AL 36362 | 2011-09-19 |
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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.