WOMACK ARMY MEDICAL CENTER (NPI# 1356907471) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356907471 |
| Entity Type | Organization |
| Organization Name | WOMACK ARMY MEDICAL CENTER |
| Practice Address |
4-2817 Reilly Rd Bldg B Fort Bragg NC 28310-0001 |
| Practice Telephone | 9103960030 |
| Mailing Telephone | 9103960030 |
| Enumeration Date | 2019-05-14 |
| Last Update Date | 2019-05-14 |
| Authorized Official Name | HECTOR MORALES (CHIEF OF PASS) |
| Authorized Official Telephone | 2105366650 |
| Is Organization Subpart | Y |
| Parent Organization Name | WOMACK ARMY MEDICAL CENTER |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332000000X | Military/U.S. Coast Guard Pharmacy | Suppliers |
| Other Name | Type Code |
|---|---|
| BRAGG PACU PHCY | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891246708 | Womack Army Medical Center | Pharmacy | 1571 Reilly Rd, Bldg 4, Ft Bragg, NC 28307 | 2016-10-17 |
| 1861867293 | Womack Army Medical Center | Military Hospital | 2817 Reily Road, Fort Bragg, NC 28317 | 2015-12-10 |
| 1700250248 | Womack Army Medical Center | Rehabilitation Unit | 215 Ice Ave, 100, Dayton, OH 45402 | 2015-11-20 |
| 1205206935 | Womack Army Medical Center | Clinic/Center | 3908 Longstreet, Bldg 3-4303, Fort Bragg, NC 28310-0001 | 2015-10-07 |
| 1932577368 | Womack Army Medical Center | Military/U.S. Coast Guard Pharmacy | 55 Centennial Pkwy, Cameron, NC 28326-4013 | 2015-09-02 |
| 1578951042 | Womack Army Medical Center | Clinic/Center | 55 Centennial Parkway, Cameron, NC 28326 | 2015-01-06 |
| 1801215660 | Womack Army Medical Center | Clinic/Center | 2857 Watson St, Bldg M-1704, Fort Bragg, NC 28310-0001 | 2014-04-09 |
| 1710306576 | Womack Army Medical Center | Clinic/Center | Tagaytay Rd Bldg C-1624, Fort Bragg, NC 28310-7301 | 2014-04-09 |
| 1508285362 | Womack Army Medical Center | Clinic/Center | Kendenburg St Bldg H-6338, Fort Bragg, NC 28310-0001 | 2014-04-09 |
| 1134433402 | Womack Army Medical Center | Clinic/Center | 2356 South Peak Drive, Hope Mills, NC 28348 | 2010-07-29 |
| Street Address |
4-2817 REILLY RD BLDG B |
| City | FORT BRAGG |
| State | NC |
| Zip Code | 28310-0001 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033775150 | Womack Army Medical Center | Military/U.S. Coast Guard Pharmacy | 4-2817 Reilly Rd Bldg B, Fort Bragg, NC 28310-0001 | 2019-05-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013550763 | Brent Francis Bachman | Physician Assistant | 2817 Reilly Street, Fort Bragg, NC 28310 | 2019-10-25 |
| 1417503459 | Cooper Pasque | Dentist | 1838 Normandy Dr., Fort Bragg, Apo, AA 28310 | 2019-08-15 |
| 1851959951 | Daniel Jordan Whitaker | Student in an Organized Health Care Education/Training Program | Womack Army Medical Center, 2817 Reilly Road, Mcxc-cod Credentials, Fort Bragg, NC 28310 | 2019-06-03 |
| 1679054217 | Christopher Cetnar | Dentist | Smokebomb Hill, Bldg 3718 Gruber Road, Fort Bragg, NC 28310 | 2018-08-22 |
| 1316427107 | Alexandrea Lee Clark | Dentist | Laflamme Dental Clinic, Bldg C6238 Ardennes Road, Fort Bragg, NC 28310 | 2018-08-21 |
| 1457843831 | Kevin Patrick Hudson | Student in an Organized Health Care Education/Training Program | 2817 Reilly Road Mxcx - Cod Credentials, Womack Army Medical Center, Fort Bragg, NC 28310 | 2018-06-01 |
| 1639691462 | Margaret S Greene | Dentist | Usa Dental Health Activity Fort Bragg, Wamc Box #151 2817 Rielly Rd, Fort Bragg, NC 28310 | 2017-07-13 |
| 1912432246 | Chezdan Baker | Student in an Organized Health Care Education/Training Program | Us Army Dental Health Activity Bldg-6837 Normandy Drive, Fort Bragg, NC 28310 | 2017-04-24 |
| 1215483094 | Shantryce Monique Boatwright Crump | Dental Hygienist | 2617 Rielly Road, Fort Bragg, NC 28310 | 2016-08-31 |
| 1629435714 | John Gagnier | Physician Assistant | Gruber Road, Building #c-1722, Fort Bragg, NC 28310 | 2016-01-21 |
| Find all providers in zip 28310 | ||||
| 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 |
|---|---|---|---|---|
| 1447359732 | Womack Army Medical Center | Military/U.S. Coast Guard Pharmacy | Lane Rd Bldg M4861, Fort Bragg, NC 28310-0001 | 2006-09-22 |
| 1538268826 | Womack Army Medical Center | Military/U.S. Coast Guard Pharmacy | Butner Rd Bldg 85050, Fort Bragg, NC 28310-0001 | 2006-09-22 |
| 1093814386 | Womack Army Medical Center | Military/U.S. Coast Guard Pharmacy | Gruber Rd Bldg C1722, Fort Bragg, NC 28310-0001 | 2006-09-22 |
| 1518064369 | Womack Army Medical Center | Military/U.S. Coast Guard Pharmacy | Bastogne Dr, Bldg 54257, Fort Bragg, NC 28310-0001 | 2006-09-20 |
| 1609973452 | Womack Army Medical Center | Military/U.S. Coast Guard Pharmacy | Reily Rd Bldg 42817, Fort Bragg, NC 28310-0001 | 2006-09-20 |
| 1033775150 | Womack Army Medical Center | Military/U.S. Coast Guard Pharmacy | 4-2817 Reilly Rd Bldg B, Fort Bragg, NC 28310-0001 | 2019-05-14 |
| 1912310772 | Womack Army Medical Center | Military/U.S. Coast Guard Pharmacy | Womack Army Medical Ctr, Building 4-2817 Reilly Road, Fort Bragg, NC 28310-5000 | 2014-06-09 |
| 1376642660 | Womack Army Medical Center | Military/U.S. Coast Guard Pharmacy | Reily Rd Bldg 42817, Fort Bragg, NC 28310-0001 | 2006-09-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932577368 | Womack Army Medical Center | Military/U.S. Coast Guard Pharmacy | 55 Centennial Pkwy, Cameron, NC 28326-4013 | 2015-09-02 |
| 1427435585 | Naval Medical Center Camp Lejeune | Military/U.S. Coast Guard Pharmacy | Stone St. Extention, Bldg Nh200, Camp Lejeune, NC 28547 | 2015-04-28 |
| 1104238724 | Naval Health Clinic Cherry Point | Military/U.S. Coast Guard Pharmacy | Naval Health Clinic Cherry Point, Building 4389, Beaufort Rd, Mcas Cherry Point, NC 28533-0023 | 2014-06-02 |
| 1821400516 | Naval Medical Center Camp Lejeune | Military/U.S. Coast Guard Pharmacy | Brewster Blvd Bldg Nh100, Usn-naval Hospital, Camp Lejeune, NC 28547-0100 | 2014-05-29 |
| 1710252499 | Naval Medical Center Camp Lejeune | Military/U.S. Coast Guard Pharmacy | A Street, Bldg # Rr 440, Camp Lejeune, NC 28542-0117 | 2012-03-14 |
| 1215036546 | Naval Health Clinic Cherry Point | Military/U.S. Coast Guard Pharmacy | Bldg 4389 Beaufort St, Cherry Point, NC 28533-0023 | 2006-09-22 |
| 1568561884 | Us Coast Guard Finance Center | Military/U.S. Coast Guard Pharmacy | Weeksville Hwy Bldg 112, Elizabeth City, NC 27909 | 2006-09-22 |
| 1811305477 | 4th Medical Group | Military/U.S. Coast Guard Pharmacy | 1050 Jabara Ave, Seymour Johnson A F B, NC 27531-2310 | 2014-07-28 |
| 1508163098 | Womack Army Medical Center | Military/U.S. Coast Guard Pharmacy | 2356 South Peak Drive, Hope Mills, NC 28348 | 2011-02-17 |
| 1912204405 | Womack Army Medical Center | Military/U.S. Coast Guard Pharmacy | 2350 Bentridge Ln, Fayetteville, NC 28304-0590 | 2011-02-17 |
| Find all providers with the same taxonomy | ||||
| City | FORT BRAGG |
| Zip Code | 28310 |
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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.