MADIGAN ARMY MEDICAL CTR (NPI# 1700048972) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700048972 |
| Entity Type | Organization |
| Organization Name | MADIGAN ARMY MEDICAL CTR |
| Other Organization Name | MCCHORD CLINIC PHARMACY |
| Practice Address |
690 Barnes Blvd Joint Base Lewis Mcchord WA 98438-1303 |
| Mailing Address |
Madigan Army Medical Ctr 9040a Fitzsimmons Dr Tacoma WA 98431-0001 |
| Practice Telephone | 2539822478 |
| Mailing Telephone | 2102218274 |
| Mailing Fax Number | 2102218131 |
| Enumeration Date | 2008-06-30 |
| Last Update Date | 2015-07-01 |
| 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 |
|---|---|---|---|---|---|
| N | 3336C0002X |
Pharmacy Specialization: Clinic Pharmacy |
Suppliers | ||
| Y | 332000000X | Military/U.S. Coast Guard Pharmacy | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PK | 2109178 | 01 |
| Other Name | Type Code |
|---|---|
| MCCHORD CLINIC PHARMACY | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770975583 | Madigan Army Medical Ctr | Clinic/Center | Railroad Ave Bldg R3749, Tacoma, WA 98431-0001 | 2015-03-03 |
| 1528488848 | Madigan Army Medical Ctr | Military/U.S. Coast Guard Pharmacy | Madigan Army Medical Ctr 9040, Jackson Ave, Tacoma, WA 98431-1100 | 2014-04-25 |
| 1376974303 | Madigan Army Medical Ctr | Clinic/Center | 3 Rd Division Dr Bldg R3150, Tacoma, WA 98431-0001 | 2013-12-02 |
| 1588094213 | Madigan Army Medical Ctr | Clinic/Center | C St Bldg R1880, Tacoma, WA 98431-0001 | 2013-11-15 |
| 1043640774 | Madigan Army Medical Ctr | Clinic/Center | Railroad Ave Bldg R3742, Tacoma, WA 98431-0001 | 2013-11-15 |
| 1750719761 | Madigan Army Medical Ctr | Clinic/Center | 5 Th St Bldg 9025, Tacoma, WA 98431-0001 | 2013-10-30 |
| 1801152723 | Madigan Army Medical Ctr | Clinic/Center | 13815 8th St, Joint Base Lewis Mcchord, WA 98431-0001 | 2012-04-04 |
| 1316243744 | Madigan Army Medical Ctr | Military/U.S. Coast Guard Pharmacy | 10507 156th St E, Suite 112, Puyallup, WA 98374-9361 | 2011-02-02 |
| 1851605356 | Madigan Army Medical Ctr | Clinic/Center | 15600 Meridan Ave, Sunrise Village Center, East Puyallup, WA 98374 | 2010-07-27 |
| 1881907822 | Madigan Army Medical Ctr | Clinic/Center | 3415 Pacific Ave Se, Suite D1, Olympia, WA 98501-2173 | 2010-07-20 |
| Street Address |
690 BARNES BLVD |
| City | JOINT BASE LEWIS MCCHORD |
| State | WA |
| Zip Code | 98438-1303 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083600068 | Kathleen Greenhalgh | Nurse Practitioner | 690 Barnes Blvd, Joint Base Lewis Mcchord, WA 98438-1303 | 2005-09-23 |
| 1982175113 | Miguel Antonio Rodriguez Jr. | Military Health Care Provider | 690 Barnes Blvd, Joint Base Lewis Mcchord, WA 98438-1303 | 2018-12-16 |
| 1184135428 | Eric Logan Dorner | Case Manager/Care Coordinator | 690 Barnes Blvd, Joint Base Lewis Mcchord, WA 98438-1303 | 2017-10-13 |
| 1952812349 | Jodie Mitchell | Case Manager/Care Coordinator | 690 Barnes Blvd, Joint Base Lewis Mcchord, WA 98438-1303 | 2017-10-12 |
| 1093226458 | Jayce Moody | Dental Hygienist | 690 Barnes Blvd, Joint Base Lewis Mcchord, WA 98438-1303 | 2017-10-12 |
| 1861916801 | Christopher D Lucio Strayer | Military Health Care Provider | 690 Barnes Blvd, Joint Base Lewis Mcchord, WA 98438-1303 | 2017-08-01 |
| 1154877645 | Chanel Pedersen | Licensed Practical Nurse | 690 Barnes Blvd, Joint Base Lewis Mcchord, WA 98438-1303 | 2016-08-25 |
| 1063864809 | Tom Thomas | Registered Nurse | 690 Barnes Blvd, Joint Base Lewis Mcchord, WA 98438-1303 | 2016-07-05 |
| 1407228737 | Jamye Patrice Gore | Nurse Practitioner | 690 Barnes Blvd, Joint Base Lewis Mcchord, WA 98438-1303 | 2015-10-26 |
| 1922488360 | Alexander Dominic Jobrack | Preventive Medicine | 690 Barnes Blvd, Joint Base Lewis Mcchord, WA 98438-1336 | 2015-06-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457810483 | Roveds Kaarins | Nursing Care | Mcchord Air Force Base Clinic, 690 Barnes Blvd Jblm Lakewood Wa, Apo, AA 98438 | 2019-03-19 |
| 1326459843 | Dr Larsen Eye Care Inc | Optometrist | 504 A St Mcchord Main Exchange, Ft. Lewis Mcchord Afb, WA 98438 | 2014-05-19 |
| 1548580392 | Kevin Lok | Family Medicine | 600 Barnes Blvd., Mcchord Medical Clinic, Jblm, WA 98438 | 2010-06-03 |
| 1720205578 | Nathan Kane Fosmore | Registered Nurse | Us Dept of The Us Airforce, 690 Barnes Blvd, Mcchord Afb, WA 98438 | 2007-04-20 |
| 1225176951 | Ronald Richardson Morris | Family Medicine | 690 Barnes Road, Mcchord Medical Clinic Fam Med Clinic, Joint Base Lewis Mcchord, WA 98438 | 2007-02-02 |
| 1770527418 | National Vision, Inc. | Eyewear Supplier (Equipment, not the service) | A Street Bldg 504, Mcchord Afb, WA 98438 | 2006-06-15 |
| 1982660692 | Shanti Jones | Registered Nurse | 62nd Med Group, 690 Barnes Ave, Mcchord Afb, WA 98438 | 2006-04-21 |
| 1578547436 | Cynthia Lee Fry-spray | Physician Assistant | 691 Barnes Blvd, Mcchord Afb, WA 98438 | 2005-12-05 |
| 1366432171 | Robert Dean Rock | Dentist | 527 Barnes Blvd, Mcchord Air Forse Base Dental Clinic, Mcchord, WA 98438 | 2005-10-24 |
| 1457344913 | Norman Harris | Dentist | 62mdos/sgod 690 Barnes Blvd., Mcchord Afb, WA 98438 | 2005-08-30 |
| Find all providers in zip 98438 | ||||
| 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 |
|---|---|---|---|---|
| 1528488848 | Madigan Army Medical Ctr | Military/U.S. Coast Guard Pharmacy | Madigan Army Medical Ctr 9040, Jackson Ave, Tacoma, WA 98431-1100 | 2014-04-25 |
| 1518387836 | Naval Health Clinic Oak Harbor | Military/U.S. Coast Guard Pharmacy | Naval Hospital Oak Hbr 3475 N Saratoga St, Oak Harbor, WA 98278-8800 | 2014-04-25 |
| 1205102761 | 92nd Medical Group | Military/U.S. Coast Guard Pharmacy | 103 Saatz Rd, Fairchild Afb, WA 99011 | 2012-03-29 |
| 1801195110 | 92 Medical Group/sgsl | Military/U.S. Coast Guard Pharmacy | 6955 22nd Ave Ne, # 3401, Moses Lake, WA 98837-3288 | 2011-03-25 |
| 1316243744 | Madigan Army Medical Ctr | Military/U.S. Coast Guard Pharmacy | 10507 156th St E, Suite 112, Puyallup, WA 98374-9361 | 2011-02-02 |
| 1992804033 | Madigan Army Medical Ctr | Military/U.S. Coast Guard Pharmacy | Bldg 2202, Ft Lewis, WA 98433 | 2006-09-22 |
| 1275632317 | 92nd Medical Group | Military/U.S. Coast Guard Pharmacy | Bldg 2460, Fairchild Afb, WA 99011 | 2006-09-22 |
| 1609975747 | Madigan Army Medical Ctr | Military/U.S. Coast Guard Pharmacy | Bldg 9040a, Tacoma, WA 98431-0001 | 2006-09-22 |
| 1336248475 | Pt Angeles Uscg Phcy | Military/U.S. Coast Guard Pharmacy | Ediz Hook Rd, Port Angeles, WA 98362 | 2006-09-22 |
| 1619076650 | Madigan Army Medical Ctr | Military/U.S. Coast Guard Pharmacy | Jackson Ave Bldg 9040a, Tacoma, WA 98431-0001 | 2006-09-22 |
| Find all providers with the same taxonomy | ||||
| City | JOINT BASE LEWIS MCCHORD |
| Zip Code | 98438 |
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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.