MADIGAN ARMY MEDICAL CTR (NPI# 1316243744) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316243744 |
| Entity Type | Organization |
| Organization Name | MADIGAN ARMY MEDICAL CTR |
| Other Organization Name | MADIGAN PUYALLUP PHCY |
| Practice Address |
10507 156th St E Suite 112 Puyallup WA 98374-9361 |
| Mailing Address |
9040a Jackson Ave Attn: Mchj-csa-u Tacoma WA 98431-0001 |
| Practice Telephone | 2533075433 |
| Mailing Telephone | 2539686598 |
| Enumeration Date | 2011-02-02 |
| Last Update Date | 2012-12-21 |
| Authorized Official Name | HECTOR MORALES (DEPUTY DIRECTOR OF PHARMACY OPS) |
| Authorized Official Telephone | 2102218274 |
| Is Organization Subpart | Y |
| Parent Organization Name | MADIGAN ARMY MEDICAL CTR |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332000000X | Military/U.S. Coast Guard Pharmacy | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PARENT BILLING FACILITY NPI | 1841390077 | 01 | |
| FACILITY NPI | 1851605356 | 01 | |
| NCPDP | 4933924 | 01 |
| Other Name | Type Code |
|---|---|
| MADIGAN PUYALLUP PHCY | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770975583 | Madigan Army Medical Ctr | Clinic/Center | Railroad Ave Bldg R3749, Tacoma, WA 98431-0001 | 2015-03-03 |
| 1528488848 | Madigan Army Medical Ctr | Military/U.S. Coast Guard Pharmacy | Madigan Army Medical Ctr 9040, Jackson Ave, Tacoma, WA 98431-1100 | 2014-04-25 |
| 1376974303 | Madigan Army Medical Ctr | Clinic/Center | 3 Rd Division Dr Bldg R3150, Tacoma, WA 98431-0001 | 2013-12-02 |
| 1588094213 | Madigan Army Medical Ctr | Clinic/Center | C St Bldg R1880, Tacoma, WA 98431-0001 | 2013-11-15 |
| 1043640774 | Madigan Army Medical Ctr | Clinic/Center | Railroad Ave Bldg R3742, Tacoma, WA 98431-0001 | 2013-11-15 |
| 1750719761 | Madigan Army Medical Ctr | Clinic/Center | 5 Th St Bldg 9025, Tacoma, WA 98431-0001 | 2013-10-30 |
| 1801152723 | Madigan Army Medical Ctr | Clinic/Center | 13815 8th St, Joint Base Lewis Mcchord, WA 98431-0001 | 2012-04-04 |
| 1851605356 | Madigan Army Medical Ctr | Clinic/Center | 15600 Meridan Ave, Sunrise Village Center, East Puyallup, WA 98374 | 2010-07-27 |
| 1881907822 | Madigan Army Medical Ctr | Clinic/Center | 3415 Pacific Ave Se, Suite D1, Olympia, WA 98501-2173 | 2010-07-20 |
| 1497952667 | Madigan Army Medical Ctr | Clinic/Center | Building R3125, Bennett Avenue, Fort Lewis, WA 98433 | 2007-06-29 |
| Street Address |
10507 156TH ST E SUITE 112 |
| City | PUYALLUP |
| State | WA |
| Zip Code | 98374-9361 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073173977 | Courtney Yant | Registered Nurse | 300 3rd St Se, Puyallup, WA 98374 | 2019-06-13 |
| 1013480508 | Tracy Pina | Massage Therapist | 16909 123rd Ave E, Puyallup, WA 98374 | 2019-01-07 |
| 1922524917 | Edith M Wood | Registered Nurse | 13517 152nd St Ct E, Puyallup, WA 98374 | 2017-08-21 |
| 1669875993 | Jillian C S Longway | Registered Nurse | 11102 Sunrise Blvd E Ste 103, Puyallup, WA 98374 | 2014-10-01 |
| 1427302025 | Nadeem Jaffer | Internal Medicine | 3800 3rd St. Se, Puyallup, WA 98374 | 2012-11-04 |
| 1851605356 | Madigan Army Medical Ctr | Clinic/Center | 15600 Meridan Ave, Sunrise Village Center, East Puyallup, WA 98374 | 2010-07-27 |
| 1326368135 | Matt Karl Jahns | Massage Therapist | 2402 20th St Se, Puyallup, WA 98374 | 2010-06-03 |
| 1982833208 | Roxy Sturgeon | Speech-Language Pathologist | 2309 43rd Ave Se, Puyallup, WA 98374 | 2009-07-08 |
| 1497921191 | Morgan Counseling Services Inc. | Substance Abuse Rehabilitation Facility | 10312 120th Street East, Suite #3, Puyallup, WA 98374 | 2008-05-02 |
| 1700055795 | Walter Royal Patterson Jr. | Registered Nurse | 11102 Sunrise Blvd. E., Ste. 103, Woodcreek Healthcare, Puyallup, WA 98374 | 2008-02-25 |
| Find all providers in zip 98374 | ||||
| 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 |
|---|---|---|---|---|
| 1528488848 | Madigan Army Medical Ctr | Military/U.S. Coast Guard Pharmacy | Madigan Army Medical Ctr 9040, Jackson Ave, Tacoma, WA 98431-1100 | 2014-04-25 |
| 1518387836 | Naval Health Clinic Oak Harbor | Military/U.S. Coast Guard Pharmacy | Naval Hospital Oak Hbr 3475 N Saratoga St, Oak Harbor, WA 98278-8800 | 2014-04-25 |
| 1205102761 | 92nd Medical Group | Military/U.S. Coast Guard Pharmacy | 103 Saatz Rd, Fairchild Afb, WA 99011 | 2012-03-29 |
| 1801195110 | 92 Medical Group/sgsl | Military/U.S. Coast Guard Pharmacy | 6955 22nd Ave Ne, # 3401, Moses Lake, WA 98837-3288 | 2011-03-25 |
| 1992804033 | Madigan Army Medical Ctr | Military/U.S. Coast Guard Pharmacy | Bldg 2202, Ft Lewis, WA 98433 | 2006-09-22 |
| 1275632317 | 92nd Medical Group | Military/U.S. Coast Guard Pharmacy | Bldg 2460, Fairchild Afb, WA 99011 | 2006-09-22 |
| 1609975747 | Madigan Army Medical Ctr | Military/U.S. Coast Guard Pharmacy | Bldg 9040a, Tacoma, WA 98431-0001 | 2006-09-22 |
| 1336248475 | Pt Angeles Uscg Phcy | Military/U.S. Coast Guard Pharmacy | Ediz Hook Rd, Port Angeles, WA 98362 | 2006-09-22 |
| 1619076650 | Madigan Army Medical Ctr | Military/U.S. Coast Guard Pharmacy | Jackson Ave Bldg 9040a, Tacoma, WA 98431-0001 | 2006-09-22 |
| 1477652519 | 92nd Medical Group | Military/U.S. Coast Guard Pharmacy | 701 Hospital Loop # 135, Fairchild Afb, WA 99011-8704 | 2006-09-22 |
| 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.