KINGS BAY PHARMACY (NPI# 1376640128) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376640128 |
| Entity Type | Organization |
| Organization Name | KINGS BAY PHARMACY |
| Practice Address |
881 Uss James Madison Rd Bldg 1028 Navsubase Kings Bay GA 31547-2531 |
| Practice Telephone | 9126734264 |
| Practice Fax Number | 9126733761 |
| Mailing Telephone | 9126734264 |
| Mailing Fax Number | 9126733761 |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2017-10-15 |
| Authorized Official Name | WILLIAM M CONDON (BUMED UBO) |
| Authorized Official Telephone | 2404013643 |
| 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 | 2020385 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467566430 | Kings Bay Pharmacy | Pharmacy | 2927 Avenue S, Brooklyn, NY 11229-3231 | 2006-08-18 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| New York State Corporations | KINGS BAY PHARMACY, INC. | Super Value Drugs, 2927 Avenue S, Brooklyn, Ny 11229 |
| Street Address |
881 USS JAMES MADISON RD BLDG 1028 NAVSUBASE |
| City | KINGS BAY |
| State | GA |
| Zip Code | 31547-2531 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265844773 | Kings Bay Refill Pharmacy | Military/U.S. Coast Guard Pharmacy | 881 Uss James Madison Rd Bldg 1028, Naval Health Clinic Kings Bay, Kings Bay, GA 31547-2531 | 2014-06-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922316785 | D'metric Maudell Moss | Nurse's Aide | 881 Uss James Madison Raod, Naval Submarine Base, Kings Bay, GA 31547 | 2010-09-15 |
| 1023291788 | Jay D Carson | Military Health Care Provider | 1050 Uss Gerogia Ave, Kings Bay, GA 31547 | 2007-12-17 |
| 1568651321 | Westley Michael Durnell | Military Health Care Provider | 580 Uss Mariano G. Vallejo Ave, Nssc Medical, Kings Bay, GA 31547 | 2007-10-17 |
| 1013127497 | Cory Dean Sant | Military Health Care Provider | Uss Rhode Island Ssbn 740 (blue), 1059 Uss Georgia Ave, Kings Bay, GA 31547 | 2007-05-23 |
| 1982760492 | Rufus Benjamin Phillips | Pharmacist | Kingsbay Naval Base, Pharmacy, Kingsbay, GA 31547 | 2006-12-29 |
| 1083626949 | Michael Dennis Lappi | Preventive Medicine | Naval Branch Health Clinic Kings Bay, Kings Bay, GA 31547 | 2006-08-12 |
| 1578592838 | Eric Windsor Larson Sr. | Military Health Care Provider | 580 Uss Mariano G Vallejo Ave, Nssc Medical Kings Bay, Kings Bay, GA 31547 | 2006-06-30 |
| 1104894294 | Cary Grinold | Nurse Practitioner | 881 Uss James Madison Road, Naval Ambulatory Care Center, Kings Bay, GA 31547 | 2006-03-14 |
| 1144429507 | Tony Wayne Lyle | Military Health Care Provider | 1061 Uss Tennessee Ave, Kings Bay, GA 31547 | 2007-07-16 |
| 1801853874 | Barry Wayne Downing | Military Health Care Provider | 881 Uss James Madison Rd, Kings Bay, GA 31547 | 2006-04-26 |
| Find all providers in zip 31547 | ||||
| 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 |
|---|---|---|---|---|
| 1265844773 | Kings Bay Refill Pharmacy | Military/U.S. Coast Guard Pharmacy | 881 Uss James Madison Rd Bldg 1028, Naval Health Clinic Kings Bay, Kings Bay, GA 31547-2531 | 2014-06-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023378403 | Martin Army Community Hospital | Military/U.S. Coast Guard Pharmacy | 1100 Brookstone Centre Pkwy Rm 128, Columbus, GA 31904-4577 | 2012-05-21 |
| 1477811149 | Winn - Third Party Insurance | Military/U.S. Coast Guard Pharmacy | Bldg 8435, 306 Vanguard Road, Ft Stewart, GA 31314 | 2012-05-01 |
| 1992009401 | Martin Army Community Hospital | Military/U.S. Coast Guard Pharmacy | 6998 Old Cusseta Rd Bldg 4202, Fort Benning, GA 31905-5431 | 2010-12-28 |
| 1427131432 | Eisenhower Army Medical Center | Military/U.S. Coast Guard Pharmacy | 29709 B Street, Fort Gordon, GA 30905-5741 | 2006-10-23 |
| 1790875029 | Winn-third Party Insurance | Military/U.S. Coast Guard Pharmacy | Hunter Af Bldg, Bldg 1450, Savannah, GA 31409 | 2006-10-16 |
| 1457450066 | Eisenhower Army Medical Center | Military/U.S. Coast Guard Pharmacy | Bldg 366, Ft Macpherson, GA 30330-5000 | 2006-09-21 |
| 1497854160 | Eisenhower Army Medical Center | Military/U.S. Coast Guard Pharmacy | East Hospital Rd, Bldg 300 Rm 2c22, Ft Gordon, GA 30905 | 2006-09-21 |
| 1649379314 | Martin Army Community Hospital | Military/U.S. Coast Guard Pharmacy | Marne Rd Bldg 9200, Ft Benning, GA 31905 | 2006-09-21 |
| 1548369150 | Martin Army Community Hospital | Military/U.S. Coast Guard Pharmacy | Marne Rd Bldg 9230, Ft Benning, GA 31905 | 2006-09-21 |
| 1215036983 | Eisenhower Army Medical Center | Military/U.S. Coast Guard Pharmacy | Avenue B Bldg 29709, Mark Connelly Health Clinic, Ft Gordon, GA 30905 | 2006-09-21 |
| 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.