BLANCHFIELD ARMY COMMUNITY HOSPITAL (NPI# 1366549115) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366549115 |
| Entity Type | Organization |
| Organization Name | BLANCHFIELD ARMY COMMUNITY HOSPITAL |
| Other Organization Name | CAMPB LHC PHCY |
| Practice Address |
5979 Desert Storm Ave Fort Campbell KY 42223-5514 |
| Practice Telephone | 2709560374 |
| Practice Fax Number | 2707988065 |
| Mailing Telephone | 2709560374 |
| Mailing Fax Number | 2707988065 |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2017-02-15 |
| 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 | 2033104 | 01 |
| Other Name | Type Code |
|---|---|
| CAMPB LHC PHCY | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942783246 | Blanchfield Army Community Hospital | Military/U.S. Coast Guard Pharmacy | Bldg 110 Pharm Usa Health Clinic, Rock Island, IL 61299-0001 | 2018-09-12 |
| 1396145306 | Blanchfield Army Community Hospital | Clinic/Center | Bldg 2403, Air Assault St and Indiana Ave, Fort Campbell, KY 42223 | 2014-08-27 |
| 1659785053 | Blanchfield Army Community Hospital | Clinic/Center | Bldg 6747 A Shau Valley Road, Fort Campbell, KY 42223 | 2014-06-13 |
| 1215340401 | Blanchfield Army Community Hospital | Military/U.S. Coast Guard Pharmacy | 98a Michigan Ave, Fort Campbell, KY 42223-5622 | 2014-06-05 |
| 1336575497 | Blanchfield Army Community Hospital | Clinic/Center | Toccoa Road Bldg 70344, Fort Campbell, KY 42223-5318 | 2013-09-20 |
| 1518393677 | Blanchfield Army Community Hospital | Clinic/Center | 53rd Street and Indiana Ave, Bldg 3929, Fort Campbell, KY 42223-5318 | 2013-09-20 |
| 1427484583 | Blanchfield Army Community Hospital | Clinic/Center | 55th Street and Indiana Avenue, Bldg 3960, Fort Campbell, KY 42223-5318 | 2013-09-20 |
| 1154757219 | Blanchfield Army Community Hospital | Clinic/Center | 30th Street and Desert Storm Avenue, Bldg 6988, Fort Campbell, KY 42223-5318 | 2013-09-20 |
| 1376982413 | Blanchfield Army Community Hospital | Military/U.S. Coast Guard Pharmacy | 650 Joel Dr Bldg B, Fort Campbell, KY 42223-5318 | 2013-06-21 |
| 1457643231 | Blanchfield Army Community Hospital | Military/U.S. Coast Guard Pharmacy | Bldg 7973 Strike Blvd, Fort Campbell, KY 42223 | 2011-05-11 |
| Street Address |
5979 DESERT STORM AVE |
| City | FORT CAMPBELL |
| State | KY |
| Zip Code | 42223-5514 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124584289 | Brian Joseph Caston | Physician Assistant | 5979 Desert Storm Ave, Fort Campbell, KY 42223-5514 | 2019-02-13 |
| 1093255275 | Richard Thomas Ahlstrom | Physician Assistant | 5979 Desert Storm Ave, Fort Campbell, KY 42223-5514 | 2017-03-07 |
| 1205382744 | Michael Marley | Physician Assistant | 5979 Desert Storm Ave, Fort Campbell, KY 42223-5514 | 2016-08-25 |
| 1265855811 | Christopher Lawson | Audiologist | 5979 Desert Storm Ave, Audiology, Lapointe Health Clinic, Fort Campbell, KY 42223-5585 | 2014-01-31 |
| 1447520630 | Sharleen Marie Rupp | Audiologist | 5979 Desert Storm Ave, Fort Campbell, KY 42223-5514 | 2012-01-05 |
| 1982992392 | Bryan Clay Christiansen | Physical Therapist | 5979 Desert Storm Ave, C/o La Pointe Physical Therapy, Fort Campbell, KY 42223-5585 | 2011-07-19 |
| 1104113018 | Vlatka Splajt Plymale | General Practice | 5979 Desert Storm Ave, Fort Campbell, KY 42223-5585 | 2011-06-30 |
| 1649582685 | Alain Michael Pagaduan Abellada | Military Health Care Provider | 5979 Desert Storm Ave, Fort Campbell, KY 42223 | 2010-07-07 |
| 1922338672 | Christopher Jason Lee | Physician Assistant | 5979 Desert Storm Ave, Lapointe Health Clinic, Fort Campbell, KY 42223-5585 | 2009-12-31 |
| 1164668711 | Linda Allen | Licensed Practical Nurse | 5979 Desert Storm Ave, Fort Campbell, KY 42223-5585 | 2009-01-05 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558978825 | Eden Addisu Kebede | Social Worker | Ft. Campbell/bach, 650 Joel Drive, Fort Campbell, KY 42223 | 2020-09-30 |
| 1174134662 | Lucas Pepper | Dentist | Desert Storm Ave, Bldg 5580, Apo, AA 42223 | 2020-08-10 |
| 1639711203 | Travis Robert Bryant | Optometrist | 5979 Desert Storm Ave., Lapointe Health Clnic Optometry, Ft. Campbell, KY 42223 | 2019-10-15 |
| 1184138232 | Vanessa Renee Simmons | Dental Assistant | 302b Baker St, Fort Campbell, KY 42223 | 2017-11-28 |
| 1922451996 | Isabella Julson | Dental Assistant | Bldg2441 21st Street, Us Army Dental Activity, Fort Campbell, KY 42223 | 2016-07-14 |
| 1336595305 | Heidi Cameron | Acupuncturist | 2889b Idaho Avenue, Fort Campbell, KY 42223 | 2016-05-10 |
| 1649644154 | Nathan Silvey | Physician Assistant | Building 4179, Fort Campbell, KY 42223 | 2015-11-20 |
| 1396145306 | Blanchfield Army Community Hospital | Clinic/Center | Bldg 2403, Air Assault St and Indiana Ave, Fort Campbell, KY 42223 | 2014-08-27 |
| 1275948564 | Rodney C Merkley | Psychologist | Building 3929, Ft. Capmbell, KY 42223 | 2014-06-25 |
| 1659785053 | Blanchfield Army Community Hospital | Clinic/Center | Bldg 6747 A Shau Valley Road, Fort Campbell, KY 42223 | 2014-06-13 |
| Find all providers in zip 42223 | ||||
| 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 |
|---|---|---|---|---|
| 1215340401 | Blanchfield Army Community Hospital | Military/U.S. Coast Guard Pharmacy | 98a Michigan Ave, Fort Campbell, KY 42223-5622 | 2014-06-05 |
| 1376982413 | Blanchfield Army Community Hospital | Military/U.S. Coast Guard Pharmacy | 650 Joel Dr Bldg B, Fort Campbell, KY 42223-5318 | 2013-06-21 |
| 1457643231 | Blanchfield Army Community Hospital | Military/U.S. Coast Guard Pharmacy | Bldg 7973 Strike Blvd, Fort Campbell, KY 42223 | 2011-05-11 |
| 1730288366 | Blanchfield Army Community Hospital | Military/U.S. Coast Guard Pharmacy | 650 Joel Dr Rm 1bg01, Blanchfield Army Comm Hosp, Fort Campbell, KY 42223-5318 | 2006-09-21 |
| 1275630022 | Blanchfield Army Community Hospital | Military/U.S. Coast Guard Pharmacy | 650 Joel Dr Bldg 98, Fort Campbell, KY 42223-5318 | 2006-09-20 |
| 1649379272 | Blanchfield Army Community Hospital | Military/U.S. Coast Guard Pharmacy | 650 Joel Dr Rm 1bg01, Blanchfield Army Comm Hosp, Fort Campbell, KY 42223-5318 | 2006-09-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528276516 | Ireland Army Community Hospital | Military/U.S. Coast Guard Pharmacy | Bldg 5949 15th Calvary Div Rd, Fort Knox, KY 40121-5111 | 2007-05-21 |
| 1558460188 | Ireland Army Community Hospital | Military/U.S. Coast Guard Pharmacy | Bldg 127, Gold Vault Rd, Ft Knox, KY 40121 | 2006-09-21 |
| 1871692418 | Blanchfield Army Community Hospital | Military/U.S. Coast Guard Pharmacy | Building 103, Blanchfield Army Comm Hosp, Ft Campbell, KY 42223 | 2006-09-21 |
| 1114026747 | Blanchfield Army Community Hospital | Military/U.S. Coast Guard Pharmacy | Post Exchange, Building 2840, Ft Campbell, KY 42223 | 2006-09-21 |
| 1780783324 | Ireland Army Community Hospital | Military/U.S. Coast Guard Pharmacy | 15th Cav Rd Bldg 5949, Ft Knox, KY 40121 | 2006-09-21 |
| 1679986863 | Ireland Army Community Hospital | Military/U.S. Coast Guard Pharmacy | 289 Ireland Ave, Ireland Army Community Hospital, Fort Knox, KY 40121-5111 | 2014-06-05 |
| 1184721938 | Ireland Army Community Hospital | Military/U.S. Coast Guard Pharmacy | 851 Ireland Ave, Fort Knox, KY 40121-2722 | 2006-09-20 |
| City | FORT CAMPBELL |
| Zip Code | 42223 |
Please comment or provide details below to improve the information on BLANCHFIELD ARMY COMMUNITY HOSPITAL.
| 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.