66 MDSS-SGSR (NPI# 1649684473) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649684473 |
| Entity Type | Organization |
| Organization Name | 66 MDSS-SGSR |
| Other Organization Name | DOD HANSCOM EPHCY |
| Practice Address |
90 Vandenberg Dr Bldg 1900 Hanscom Afb MA 01731-2104 |
| Mailing Address |
66 Mdss-sgsr C/o Travis J. Ingrodi 90 Vandenberg Dr. Bldg 1900 Hanscom Afb MA 01731-2104 |
| Practice Telephone | 7812256173 |
| Practice Fax Number | 7812252577 |
| Mailing Telephone | 7812256173 |
| Mailing Fax Number | 7812252577 |
| Enumeration Date | 2014-06-19 |
| Last Update Date | 2015-06-18 |
| 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 | 2146407 | 01 |
| Other Name | Type Code |
|---|---|
| DoD HANSCOM ePhcy | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760581185 | 66 Mdss-sgsr | Military/U.S. Coast Guard Pharmacy | 90 Vandenberg Dr Bldg 1900, Hanscom Afb, MA 01731-2104 | 2006-09-22 |
| 1508831553 | 66 Mdss-sgsr | Clinic/Center | 90 Vandenberg Dr, Bldg 1900, Hanscom Afb, MA 01731-2104 | 2006-02-22 |
| Street Address |
90 VANDENBERG DR BLDG 1900 |
| City | HANSCOM AFB |
| State | MA |
| Zip Code | 01731-2104 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760581185 | 66 Mdss-sgsr | Military/U.S. Coast Guard Pharmacy | 90 Vandenberg Dr Bldg 1900, Hanscom Afb, MA 01731-2104 | 2006-09-22 |
| 1164807350 | Thuc Tran Van Pham | Pharmacist | 90 Vandenberg Dr Bldg 1900, 66 Mds (afmc), Hanscom Afb, MA 01731-2104 | 2015-07-29 |
| 1992190490 | Sandra Elizabeth Colucci | Pharmacist | 90 Vandenberg Dr Bldg 1900, Hanscom Afb, MA 01731-2104 | 2015-04-01 |
| 1205253994 | Rebecca Charette | Physician Assistant | 90 Vandenberg Dr Bldg 1900, Hanscom Afb, MA 01731-2104 | 2014-03-20 |
| 1285986646 | Justin Scott Farmer | Physician Assistant | 90 Vandenberg Dr Bldg 1900, 66 Mds, Hanscom Afb, MA 01731-2104 | 2012-10-10 |
| 1972860187 | Glenn Emery Degere | Social Worker | 90 Vandenberg Dr Bldg 1900, Hanscom Afb, MA 01731-2104 | 2012-04-12 |
| 1316276280 | John Doleski | Social Worker | 90 Vandenberg Dr Bldg 1900, Hanscom Afb, MA 01731-2104 | 2009-12-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386114171 | Aletha Juah Thomas | Nurse's Aide | 1 Freedom Cir, Hanscom Afb, MA 01731 | 2018-12-05 |
| 1730609793 | Christopher M. Congemi | Dentist | 66mds (afmc), 90 Vandenberg Dr, Bldg 1900, Hanscom Afb, MA 01731 | 2017-06-21 |
| 1184011322 | Usv Optical Inc. | Eyewear Supplier (Equipment, not the service) | 100 Elgin St, Bldg 1709 B, Hanscom Afb, MA 01731 | 2015-04-24 |
| 1578822912 | Sunland Optical Co., Inc. | Eyewear Supplier (Equipment, not the service) | Hanscom Afb, Building 1709, Bedford, MA 01731 | 2012-05-04 |
| 1215099858 | Paul R. Rivest | Psychologist | 66th Mdg Sgoh, Hanscom Afb, MA 01731 | 2006-12-13 |
| 1497837843 | Mara Salis | Social Worker | 2 Eglin St, Hanscom Afb, MA 01731 | 2006-10-19 |
| 1790749398 | Lakshmi Kona | Internal Medicine | 1609 Eglin Street, Hanscon Afb, MA 01731 | 2006-04-12 |
| 1245210715 | Jay Scott Cloutier | Physical Therapist | 66 Mdg/sgo, 90 Vandeberg Ave, Hanscom Afb, MA 01731 | 2006-01-19 |
| 1972589828 | Aron R. Potter | Psychologist | 90 Vandenberg Drive, Bldg 1900 66 Mds (afmc), Hanscom Afb, MA 01731 | 2005-12-21 |
| 1730160938 | Mohammed Fuad | Physician Assistant | 66 Mds (afmc), 90 Vandenberg Dr. Bldg. 1900, Hanscom Afb, MA 01731 | 2005-11-07 |
| Find all providers in zip 01731 | ||||
| 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 |
|---|---|---|---|---|
| 1760581185 | 66 Mdss-sgsr | Military/U.S. Coast Guard Pharmacy | 90 Vandenberg Dr Bldg 1900, Hanscom Afb, MA 01731-2104 | 2006-09-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114026531 | Us Coast Guard Finance Center | Military/U.S. Coast Guard Pharmacy | 427 Commercial St Isc Bldg 8, Boston, MA 02109 | 2006-09-22 |
| 1932208352 | Cape Cod Uscg Phcy | Military/U.S. Coast Guard Pharmacy | Kaehler Memorial Medical Clinic, 5201 Lee Rd Us Air Station, Cape Cod, MA 02542 | 2006-09-22 |
| City | HANSCOM AFB |
| Zip Code | 01731 |
Please comment or provide details below to improve the information on 66 MDSS-SGSR.
| 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.