RAYMOND W. BLISS ARMY HEALTH CENTER (NPI# 1306049895) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306049895 |
| Entity Type | Organization |
| Organization Name | RAYMOND W. BLISS ARMY HEALTH CENTER |
| Other Organization Name | USADC-HUACHUCA RUNION |
| Practice Address |
45005 Arizona Street Fort Huachuca AZ 85613 |
| Mailing Address |
2240 E Winrow Ave Attn Mcxj-rmd-msao Fort Huachuca AZ 85613-7079 |
| Practice Telephone | 5205331479 |
| Mailing Telephone | 5205339685 |
| Enumeration Date | 2007-06-11 |
| Last Update Date | 2015-11-17 |
| Authorized Official Name | FAYE LIVINGSTON (UBO MANAGER) |
| Authorized Official Telephone | 5205339685 |
| Is Organization Subpart | Y |
| Parent Organization Name | RAYMOND W. BLISS ARMY HEALTH CENTER |
| 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 |
| Other Name | Type Code |
|---|---|
| USADC-HUACHUCA RUNION | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477617124 | Raymond W. Bliss Army Health Center | Military/U.S. Coast Guard Pharmacy | 2w Bliss Army Health Center 45001, Ft Huachuca, AZ 85613 | 2006-12-20 |
| 1922181627 | Raymond W. Bliss Army Health Center | Clinic/Center | 2240 E Winrow Ave, Ft Huachuca, AZ 85613-7079 | 2006-10-24 |
| 1083685507 | Raymond W. Bliss Army Health Center | Clinic/Center | 2240 E. Winrow Ave, Usa Meddac, Rwbahc, Fort Huachuca, AZ 85613-7079 | 2006-02-01 |
| Street Address |
45005 ARIZONA STREET |
| City | FORT HUACHUCA |
| State | AZ |
| Zip Code | 85613 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457713794 | Robert Lee Kent Jr. | Registered Nurse | 2240 East Winrow Avenue, Fort Huachuca, AZ 85613 | 2016-03-25 |
| 1548628662 | George Fauber | Licensed Practical Nurse | 224 Winrow Ave, Usa Meddac, Rwbahc, Ft Huachuca, AZ 85613 | 2016-02-03 |
| 1013207810 | Gerald Michael Pastore | Counselor | 2240 Winrow Ave Fort Huachuca, Az, Usa Meddac, Rwbahc, Apo, AA 85613 | 2011-04-13 |
| 1477617124 | Raymond W. Bliss Army Health Center | Military/U.S. Coast Guard Pharmacy | 2w Bliss Army Health Center 45001, Ft Huachuca, AZ 85613 | 2006-12-20 |
| 1114026150 | Raymond W Bliss Army Health Center | Military/U.S. Coast Guard Pharmacy | 2 W Bliss Army Health Ctr, Bldg 45001, Ft Huachuca, AZ 85613 | 2006-09-22 |
| 1013931484 | Mark Allen Hendrickson | Internal Medicine | Rwbahc, Bldg 45001, Sierra Vista Cboc, Ft Huachuca, AZ 85613 | 2006-07-27 |
| 1972538973 | Gail Pielack | Nurse Practitioner | Rwbahc, 2240 Winrow Rd, Fort Huachuca, AZ 85613 | 2006-07-11 |
| 1093755233 | National Vision, Inc. | Eyewear Supplier (Equipment, not the service) | Optical Center, Bldg 52030, Ft. Huachuca, AZ 85613 | 2006-06-07 |
| 1336119395 | Eric Nmi Danko | Dentist | 2240 E. Winrow Ave, Us Army Dental Activity, Fort Huachuca, AZ 85613 | 2006-01-24 |
| 1245855410 | Kevin Matthew Farley | Dentist | 2240 E. Winrow Ave, Fort Huachuca, AZ 85613 | 2020-06-12 |
| Find all providers in zip 85613 | ||||
| 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 |
|---|---|---|---|---|
| 1083685507 | Raymond W. Bliss Army Health Center | Clinic/Center | 2240 E. Winrow Ave, Usa Meddac, Rwbahc, Fort Huachuca, AZ 85613-7079 | 2006-02-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508069527 | Naval Hospital Camp Pendleton | Clinic/Center | Bldg 1175, Yuma, AZ 85369 | 2007-06-07 |
| 1588635098 | Usa Meddac,rwbahc | Clinic/Center | 2240 Winrow Rd, Ft Huachuca, AZ 85613-5080 | 2006-02-01 |
| 1346455391 | Weed Army Community Hospital | Clinic/Center | 301 C St, Bldg 990, Yuma, AZ 85365-9498 | 2007-05-12 |
| 1811960149 | Raymond W. Bliss Health Cemter | Clinic/Center | 2240 E. Winrow Ave., Meddac, Ft. Huachuca, AZ 85613 | 2006-02-08 |
| 1558332080 | Raymond W Bliss Army Health Center | Clinic/Center | 2240 Winrow Rd, Ft Huachuca, AZ 85613-5080 | 2006-02-01 |
| City | FORT HUACHUCA |
| Zip Code | 85613 |
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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.