KELLER ARMY COMMUNITY HOSPITAL (NPI# 1588763841) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588763841 |
| Entity Type | Organization |
| Organization Name | KELLER ARMY COMMUNITY HOSPITAL |
| Other Organization Name | TOBYHANNA PHCY |
| Practice Address |
11 Hap Amold Blvd Tobyhanna PA 18466 |
| Mailing Address |
900 Washington Rd Attn Mcud-rmd-ubo West Point NY 10996-1109 |
| Practice Telephone | 5708957225 |
| Practice Fax Number | 5708956783 |
| Mailing Telephone | 8459388239 |
| Enumeration Date | 2006-09-22 |
| Last Update Date | 2011-03-23 |
| Authorized Official Name | HECTOR MORALES (MGR PHRMCY OPERATIONS CNTR) |
| Authorized Official Telephone | 2102218443 |
| Is Organization Subpart | Y |
| Parent Organization Name | KELLER ARMY COMMUNITY HOSPITAL |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332000000X | Military/U.S. Coast Guard Pharmacy | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OTHER ID NUMBER-COMMERCIAL NUMBER | 3979070 | 01 | |
| PARENT BILLING NPI | 1528161916 | 01 | |
| PAYMENT CENTER | 005609 | 01 |
| Other Name | Type Code |
|---|---|
| TOBYHANNA PHCY | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235334392 | Keller Army Community Hospital | Clinic/Center | 606 Cullum Road, Building 606, West Point, NY 10996 | 2007-06-19 |
| 1275747149 | Keller Army Community Hospital | Clinic/Center | 5631 Baltimore St, Fort Dix, NJ 08640-5440 | 2007-05-10 |
| 1174622542 | Keller Army Community Hospital | Pharmacy | Bldg 606, West Point, NY 10996 | 2006-09-22 |
| 1427157882 | Keller Army Community Hospital | Pharmacy | Bldg 900, West Point, NY 10996 | 2006-09-22 |
| 1912006362 | Keller Army Community Hospital | Military/U.S. Coast Guard Pharmacy | Bldg 114 Rm 175, Ft Hamilton, NY 11252 | 2006-09-22 |
| 1528167970 | Keller Army Community Hospital | Military/U.S. Coast Guard Pharmacy | 18th St and Doughboy Loop Bldg 5660, Troop Medical Health Clinic, Ft Dix, NJ 08640 | 2006-09-22 |
| 1912006685 | Keller Army Community Hospital | Clinic/Center | Bldg. 1075 Stephenson Ave., Ft. Monmouth, NJ 07703 | 2006-09-21 |
| 1861469355 | Keller Army Community Hospital | Rehabilitation Unit | 11 Hap Arnold Blvd, Health Clinic, Tobyhanna, PA 18466-5002 | 2006-03-02 |
| 1861898942 | Keller Army Community Hospital | Military/U.S. Coast Guard Pharmacy | 114 White Ave, Brooklyn, NY 11252-9503 | 2014-11-17 |
| 1497160113 | Keller Army Community Hospital | Military/U.S. Coast Guard Pharmacy | Keller Army Community Hospital, Building 900 900 Washington Road, West Point, NY 10996-1197 | 2014-06-23 |
| Street Address |
11 HAP AMOLD BLVD |
| City | TOBYHANNA |
| State | PA |
| Zip Code | 18466 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932718061 | Katelyn Mckillop | Physician Assistant | 5074 Seneca Way, Tobyhanna, PA 18466 | 2020-07-24 |
| 1508330663 | Devereux Foundation | Day Training, Developmentally Disabled Services | 11 Carriage Square, Tobyhanna, PA 18466 | 2019-01-11 |
| 1144743873 | Luisa Tieso | Psychologist | 6167 Somers Terr, Tobyhanna, PA 18466 | 2017-07-25 |
| 1982087797 | Patricia Detrick | Physical Therapy Assistant | 100 Communtiy Drive, Suite 105, Tobyhanna, PA 18466 | 2015-06-30 |
| 1376959569 | Mountain Valley Orthopedics PC | Pharmacy | 100 Community Drive Stuite 210, Tobyhanna, PA 18466 | 2014-07-08 |
| 1346674975 | Michelle Backus | Social Worker | 633 Lakeside Drive, Tobyhanna, PA 18466 | 2013-08-30 |
| 1205107067 | Sharon and Cynthia | Home Health | 9249 Westwood Dr, Tobyhanna, PA 18466 | 2012-01-25 |
| 1689942260 | Family Care Centers, Inc. | Internal Medicine | 100 Community Drive, Suite 102, Tobyhanna, PA 18466 | 2011-12-09 |
| 1942599063 | Diane Latosek | Pharmacist | 12 Carriage Square, Tobyhanna, PA 18466 | 2011-03-29 |
| 1467080846 | Katherine Moore | Social Worker | 1151 Pocono Blvd, Coolbaugh, PA 18466 | 2020-03-31 |
| Find all providers in zip 18466 | ||||
| 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 |
|---|---|---|---|---|
| 1295834455 | Willow Grove Phcy | Military/U.S. Coast Guard Pharmacy | Bmc Bldg 137, Willow Grove, PA 19090 | 2006-09-22 |
| 1992108633 | Kimbrough Acc Military Mtf | Military/U.S. Coast Guard Pharmacy | 450 Gibner Rd, Carlisle, PA 17013-5090 | 2014-10-08 |
| 1316132871 | Delaware Bay Uscg Phcy | Military/U.S. Coast Guard Pharmacy | 1 Washington Ave, Philadelphia, PA 19147-4335 | 2007-09-07 |
| 1114081866 | Walter Reed National Military Med Center | Military/U.S. Coast Guard Pharmacy | 450 Gibner Rd, Carlisle Barracks, PA 17013-5090 | 2006-12-20 |
| 1336203082 | Kimbrough Acc Military Mtf | Military/U.S. Coast Guard Pharmacy | 450 Gibner Rd, Carlisle Dunham Ata Phcy, Carlisle Barracks, PA 17013-5090 | 2006-12-20 |
| 1063574481 | Kimbrough Acc Military Mtf | Military/U.S. Coast Guard Pharmacy | 450 Gibner Rd, Carlisle Dunham Special Order Phcy, Carlisle Barracks, PA 17013-5090 | 2006-12-14 |
| 1730254152 | Kimbrough Acc Military Mtf | Military/U.S. Coast Guard Pharmacy | 450 Gibner Rd, Carlisle, PA 17013-5090 | 2006-11-21 |
| 1063519817 | Walter Reed National Military Med Center | Military/U.S. Coast Guard Pharmacy | 450 Gibner Rd, Carlisle Barracks, PA 17013-5090 | 2006-09-20 |
Please comment or provide details below to improve the information on KELLER 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.