NAVAL HEALTH CLINIC QUANTICO (NPI# 1528473774) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1528473774 |
| Entity Type | Organization |
| Organization Name | NAVAL HEALTH CLINIC QUANTICO |
| Practice Address |
3259 Catlin Ave Quantico VA 22134-5109 |
| Mailing Address |
The Treasurer of The United States 3259 Catlin Ave Quantico VA 22134-5109 |
| Practice Telephone | 7037841580 |
| Practice Fax Number | 7037841568 |
| Mailing Telephone | 7037841580 |
| Mailing Fax Number | 7037841568 |
| Enumeration Date | 2014-06-26 |
| Last Update Date | 2017-10-23 |
| Authorized Official Name | WILLIAM M CONDON (BUMED UBO) |
| Authorized Official Telephone | 2404013643 |
| Is Organization Subpart | Y |
| Parent Organization Name | NAVAL HEALTH CLINIC QUANTICO |
| 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 | 2146219 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720492093 | Naval Health Clinic Quantico | Military/U.S. Coast Guard Pharmacy | Branch Health Clinic Wny, 915 N Street S.e Bldg 175, Washington, DC 20374-5022 | 2014-06-16 |
| 1194824227 | Naval Health Clinic Quantico | Military/U.S. Coast Guard Pharmacy | Nmc 2200 Lester Avenue, Quantico, VA 22134 | 2006-09-22 |
| 1780783811 | Naval Health Clinic Quantico | Military/U.S. Coast Guard Pharmacy | Quantico Nmc Attn: Third Party Billing, 3259 Catlin Ave, Quantico, VA 22134 | 2006-09-22 |
| 1922105774 | Naval Health Clinic Quantico | Military/U.S. Coast Guard Pharmacy | 901 M St Se Bldg 183, Washington, DC 20374-0001 | 2006-09-20 |
| 1508839903 | Naval Health Clinic Quantico | Clinic/Center | 3259 Catlin Ave, Quantico, VA 22134-5109 | 2006-02-08 |
| Street Address |
3259 CATLIN AVE |
| City | QUANTICO |
| State | VA |
| Zip Code | 22134-5109 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023001831 | Ivan Roman | Dentist | 3259 Catlin Ave, Naval Health Clinic Quantico, Quantico, VA 22134 | 2005-08-26 |
| 1558987354 | Scott Alan Bauer | Optometrist | 3259 Catlin Ave, Quantico, VA 22134-5109 | 2020-06-18 |
| 1689219214 | Caitlin Rose Morgan | Nurse Practitioner | 3259 Catlin Ave, Quantico, VA 22134-5109 | 2019-11-07 |
| 1790329761 | Lindsay Elizabeth Jensen | Physician Assistant | 3259 Catlin Ave, Quantico, VA 22134-5109 | 2019-11-03 |
| 1679008312 | Lien Vinh Bao Lee | Pharmacist | 3259 Catlin Ave, Quantico, VA 22134-5109 | 2017-05-01 |
| 1447703376 | Anne Sidwell | Physical Therapist | 3259 Catlin Ave, Quantico, VA 22134-5109 | 2016-07-27 |
| 1174997324 | Keith Lee Sr. | Physical Therapist | 3259 Catlin Ave, Quantico, VA 22134-5109 | 2015-11-25 |
| 1962880344 | Lesley Michelle Washington | Registered Nurse | 3259 Catlin Ave, Quantico, VA 22134-5109 | 2015-05-18 |
| 1215314042 | Jorge Gonzalo Jara | Physician Assistant | 3259 Catlin Ave, Naval Health Clinic, Quantico, VA 22134-6050 | 2015-04-30 |
| 1144616467 | Jenna Golding | Military Health Care Provider | 3259 Catlin Ave, Quantico, VA 22134-5109 | 2015-04-14 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407413065 | Elyssa Marie Salcido | Physician Assistant | Naval Heatlh Clinic Quantico, 3259 Catlin Avenue, Quantico, VA 22134 | 2019-05-20 |
| 1396277885 | Krista Lynn Greene | Optometrist | 3259 Catilin Avenue, Naval Health Clinic, Quantico, Quantico, VA 22134 | 2017-04-03 |
| 1639526593 | Kathy Olson | Social Worker | 2134 Barnett Avenue, Little Hall Lower Level, Quantico, VA 22134 | 2016-05-20 |
| 1215285788 | Laura K Goodman | Specialist/Technologist | 12081 Mason Dr, Quantico, VA 22134 | 2012-08-15 |
| 1437441706 | Danielle Michelle Lagoski | Family Medicine | 1998 Hill Ave, Quantico, VA 22134 | 2011-05-05 |
| 1639493695 | Alicia Elizabeth Heili | Specialist/Technologist | 24164 Belleau, Quantico, VA 22134 | 2010-03-19 |
| 1598958308 | Branch Medical Clinic The Basic School | Clinic/Center | 24008 Mcb #2, Quantico, VA 22134 | 2007-08-24 |
| 1194824227 | Naval Health Clinic Quantico | Military/U.S. Coast Guard Pharmacy | Nmc 2200 Lester Avenue, Quantico, VA 22134 | 2006-09-22 |
| 1780783811 | Naval Health Clinic Quantico | Military/U.S. Coast Guard Pharmacy | Quantico Nmc Attn: Third Party Billing, 3259 Catlin Ave, Quantico, VA 22134 | 2006-09-22 |
| 1548219249 | Andrew Alexander Mcbain | Chiropractor | The Basic School Ray Health Clinic, Mcb2 24008, Quantico, VA 22134 | 2006-05-09 |
| Find all providers in zip 22134 | ||||
| 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 |
|---|---|---|---|---|
| 1194824227 | Naval Health Clinic Quantico | Military/U.S. Coast Guard Pharmacy | Nmc 2200 Lester Avenue, Quantico, VA 22134 | 2006-09-22 |
| 1780783811 | Naval Health Clinic Quantico | Military/U.S. Coast Guard Pharmacy | Quantico Nmc Attn: Third Party Billing, 3259 Catlin Ave, Quantico, VA 22134 | 2006-09-22 |
| 1346302403 | Quantico Special Order Phcy | Military/U.S. Coast Guard Pharmacy | Nmc 2200 Lester Avenue, Quantico, VA 22134 | 2006-12-15 |
| 1598864621 | Walter Reed National Military Med Center | Military/U.S. Coast Guard Pharmacy | Nmc 2200 Lester Avenue, Quantico, VA 22134 | 2006-09-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174172183 | Naval Health Clinic Annapolis | Military/U.S. Coast Guard Pharmacy | 17457 Caffee Rd Bldg 192, Dahlgren, VA 22448-5120 | 2019-09-11 |
| 1114403961 | Naval Medical Center Portsmouth | Military/U.S. Coast Guard Pharmacy | 7021 Harbor View Blvd, Suffolk, VA 23435-2869 | 2018-07-16 |
| 1437563269 | Fort Belvoir Community Hospital | Military/U.S. Coast Guard Pharmacy | 8651 John J Kingman Rd, Fort Belvoir Community Hospital, Fort Belvoir, VA 22060-6200 | 2014-06-19 |
| 1508270950 | Naval Medical Center Portsmouth | Military/U.S. Coast Guard Pharmacy | 1011 Eden Way N Ste H, Chesapeake, VA 23320-2768 | 2014-06-13 |
| 1205249059 | Naval Medical Center Portsmouth | Military/U.S. Coast Guard Pharmacy | 1647 Admiral Taussig Blvd Bldg Cd2, Norfolk, VA 23511-2803 | 2014-06-10 |
| 1467680819 | World Class Marketing Inc | Military/U.S. Coast Guard Pharmacy | 1814 Kecoughtan Rd, Suite B, Hampton, VA 23661-2834 | 2009-06-24 |
| 1609966936 | Naval Medical Center Portsmouth | Military/U.S. Coast Guard Pharmacy | Naval Weapons Station Yorktown, Bldg 1806, Yorktown, VA 23691-0090 | 2006-10-16 |
| 1982703013 | Kenner Army Health Clinic | Military/U.S. Coast Guard Pharmacy | Bldg 3219, Ft Lee, VA 23801 | 2006-09-22 |
| 1922107044 | Kenner Army Health Clinic | Military/U.S. Coast Guard Pharmacy | Bldg P8130, Ft Lee, VA 23801 | 2006-09-22 |
| 1659470771 | 1st Medical Group Sgsl | Military/U.S. Coast Guard Pharmacy | 65 Spaatz Dr, Langley Afb, VA 23665-2027 | 2006-09-22 |
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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.