96TH MEDICAL SUPPORT SQUADRON SGSL (NPI# 1275632465) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275632465 |
| Entity Type | Organization |
| Organization Name | 96TH MEDICAL SUPPORT SQUADRON SGSL |
| Other Organization Name | ARNOLD PHCY |
| Practice Address |
225 First St Bldg 225 Arnold Afb TN 37389 |
| Mailing Address |
96th Medical Support Squadron 307 Boatner Rd Ste 114 Arnold Afb TN 32542-1302 |
| Practice Telephone | 9314545351 |
| Practice Fax Number | 9314543392 |
| Mailing Telephone | 9314545351 |
| Mailing Fax Number | 9314543392 |
| Enumeration Date | 2006-09-22 |
| Last Update Date | 2015-06-02 |
| 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 | 2092941 | 01 |
| Other Name | Type Code |
|---|---|
| ARNOLD PHCY | Doing Business As Name - Organization |
| Street Address |
225 FIRST ST BLDG 225 |
| City | ARNOLD AFB |
| State | TN |
| Zip Code | 37389 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891125001 | Alexisa M Humphrey | Military Health Care Provider | 225 Von Karman Rd, Bldg 225, Arnold Afb, TN 37389 | 2013-11-25 |
| 1407090517 | Robert Louchery | Military Health Care Provider | 225 Von Karmon, First Street, Arnold Afb, TN 37389 | 2009-04-21 |
| 1427132422 | Patricia Suzanne Jackson | Family Medicine | 225 Von Karman Ave, Tullahoma Va Clinic, Arnold Afb, TN 37389 | 2006-10-25 |
| 1982700878 | Tija L Mcdaniels | Family Medicine | 225 Von Karman Road, Arnold Air Force Base, TN 37389 | 2006-09-16 |
| 1659535557 | Charles Tessier Iv | Family Medicine | 225 First Ave, Apo, AA 37389-2401 | 2008-07-10 |
| 1649372970 | Cerisia A Cummings | Emergency Medicine | 225 First St, Arnold Air Force Base, TN 37389-2402 | 2006-09-05 |
| 1104837491 | Shawnya York Black | Nurse Practitioner | 225 Von Karmon Road, Arnold Air Force Base, TN 37389-2402 | 2006-08-11 |
| 1326082546 | Nashville Vamc | Clinic/Center | 225 Von Karman Road, Arnold Air Force Base, TN 37389-9998 | 2006-06-16 |
| 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 |
|---|---|---|---|---|
| 1891095154 | Blanchfield Army Community Hospital | Military/U.S. Coast Guard Pharmacy | Cbpcc- Gateway Pharmacy, Medical Office Buldg One 647 Dunlop Lane, Suite 301, Clarrksville, TN 37040-0000 | 2010-11-02 |
| 1184723371 | Naval Hospital Pensacola | Military/U.S. Coast Guard Pharmacy | Tarawa Ave, Bldg S752, Millington, TN 38054-5201 | 2006-09-22 |
| 1477960698 | Naval Hospital Pensacola | Military/U.S. Coast Guard Pharmacy | 5722 Integrity Dr Bldg S771, Millington, TN 38054-5028 | 2014-07-21 |
| 1295926160 | Naval Hospital Pensacola | Military/U.S. Coast Guard Pharmacy | 5722 Integrity Dr, Bldg S-771, Millington, TN 38054-5028 | 2007-08-06 |
| City | ARNOLD AFB |
| Zip Code | 37389 |
Please comment or provide details below to improve the information on 96TH MEDICAL SUPPORT SQUADRON SGSL.
| 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.