DUNHAM ARMY HEALTH CLINIC


Address: 1452 Porter St, Ft Detrick, MD 21702
Phone: 3016192850

DUNHAM ARMY HEALTH CLINIC (NPI# 1679672083) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1679672083
Entity Type Organization
Organization Name DUNHAM ARMY HEALTH CLINIC
Other Organization Name DETRICK PHCY
Practice Address 1452 Porter St
Ft Detrick
MD 21702
Mailing Address 1452 Porter St
2480 Llewellyn Ave Ste 5800
Ft Detrick
MD 21702
Practice Telephone 3016192850
Practice Fax Number 3016197676
Mailing Telephone 3016192850
Mailing Fax Number 3016197676
Enumeration Date 2006-09-22
Last Update Date 2015-06-03
Authorized Official Name HECTOR MORALES (CHIEF DHA PASS)
Authorized Official Telephone 2105366650
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 332000000X Military/U.S. Coast Guard Pharmacy Suppliers

Other Provider Identifier

State Issuer Identifier Type Code
PK 2037183 01

Other Provider/Organization Names

Other Name Type Code
DETRICK PHCY Doing Business As Name - Organization

Office Location

Street Address 1452 PORTER ST
City FT DETRICK
State MD
Zip Code 21702

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Taxonomy Information

Taxonomy Code 332000000X
Grouping Suppliers
Classification Military/U.S. Coast Guard Pharmacy

Taxonomy Definition

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]

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1548868870 Walter Reed National Military Medical Center Military/U.S. Coast Guard Pharmacy 101 Buchanan Rd, Annapolis, MD 21402-5107 2020-10-09
1184273195 Naval Health Clinic Annapolis Military/U.S. Coast Guard Pharmacy 4141 W Wilson Rd Bldg 1600, Indian Head, MD 20640-5162 2019-09-11
1063763241 National Naval Medical Center Military/U.S. Coast Guard Pharmacy 8901 Wisconsin Ave Dept Ofphcy, Bldg 9, Room 2303, Bethesda, MD 20889-0001 2012-09-27
1902905318 Naval Health Clinic Patuxent River Military/U.S. Coast Guard Pharmacy Bldg 1370, Patuxent River, MD 20670 2006-09-22
1851490270 Malcom Grow Medical Center 79 Mdg Mdss Sgsr Military/U.S. Coast Guard Pharmacy 1050 W Perimeter Rd # D1119, Jb Andrews, MD 20762-6601 2006-09-22
1174620926 Naval Health Clinic Patuxent River Military/U.S. Coast Guard Pharmacy Bldg 1600 Wilson Drive, Indian Head, MD 20640 2006-09-20
1265539019 Malcom Grow Medical Center 79 Mdg Mdss Sgsr Military/U.S. Coast Guard Pharmacy 1 San Diego Loop Bldg 3188, Jb Andrews, MD 20762-5518 2006-09-20
1205242310 Kimbrough Acc Military Mtf Military/U.S. Coast Guard Pharmacy 1434 Porter St, Frederick, MD 21702-9254 2014-07-09
1649682162 Naval Health Clinic Annapolis Military/U.S. Coast Guard Pharmacy 695 Kinkaid Rd, Naval Health Clinic Annapolis, Annapolis, MD 21402 2014-06-02
1518379395 Malcolm Grow Medical Clinic 779 Mdg Military/U.S. Coast Guard Pharmacy 1060 W Perimeter Rd, Joint Base Andrews, MD 20762-6602 2014-05-28
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Competitor

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City FT DETRICK
Zip Code 21702

Improve Information

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Dataset Information

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.

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