IRELAND ARMY COMMUNITY HOSPITAL (NPI# 1700092509) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700092509 |
| Entity Type | Organization |
| Organization Name | IRELAND ARMY COMMUNITY HOSPITAL |
| Other Organization Name | OCCUPATIONAL HLTH CLINIC-FT. MCCOY |
| Practice Address |
1679 S 10th Ave Mccoy Ohc Fort Mccoy WI 54656-5114 |
| Mailing Address |
289 Ireland Ave Attn: Treasurers Office Fort Knox KY 40121-5111 |
| Practice Telephone | 6083883209 |
| Mailing Telephone | 5026249274 |
| Enumeration Date | 2007-05-16 |
| Last Update Date | 2015-04-01 |
| Authorized Official Name | BARBARA HORNBACK (UBO MANAGER) |
| Authorized Official Telephone | 5026249870 |
| Is Organization Subpart | Y |
| Parent Organization Name | IRELAND ARMY COMMUNITY HOSPITAL |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM1100X |
Clinic/Center Specialization: Military/U.S. Coast Guard Outpatient |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PARENT FACILITY IRELAND ACH NPI | 1891899274 | 01 |
| Other Name | Type Code |
|---|---|
| OCCUPATIONAL HLTH CLINIC-FT. MCCOY | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912313222 | Ireland Army Community Hospital | Military/U.S. Coast Guard Pharmacy | Bldg 110 Rodman Ave., Rock Island Arsenal, IL 61299-7240 | 2014-07-08 |
| 1801039417 | Ireland Army Community Hospital | Military/U.S. Coast Guard Pharmacy | Evans Road, Bldg 2, Camp Atterbury, IN 46124-5000 | 2009-04-13 |
| 1316142631 | Ireland Army Community Hospital | Clinic/Center | Bldg 2 Evans Road, Camp Atterbury, IN 46124 | 2007-06-18 |
| 1225233547 | Ireland Army Community Hospital | Clinic/Center | 2724 Brave Rifles Regiment Avenue, Fort Knox, KY 40121 | 2007-06-18 |
| 1528276516 | Ireland Army Community Hospital | Military/U.S. Coast Guard Pharmacy | Bldg 5949 15th Calvary Div Rd, Fort Knox, KY 40121-5111 | 2007-05-21 |
| 1740496124 | Ireland Army Community Hospital | Clinic/Center | Bldg 2 Evans Rd, Camp Atterbury, IN 46124 | 2007-05-15 |
| 1104032754 | Ireland Army Community Hospital | Clinic/Center | 2091 Kingston Hwy, Attn Blue Grass Health Clinic, Richmond, KY 40475-5000 | 2007-05-14 |
| 1841405388 | Ireland Army Community Hospital | Military/U.S. Coast Guard Pharmacy | 110 Rodman Ave, Rock Island, IL 61299-0001 | 2007-05-10 |
| 1922142991 | Ireland Army Community Hospital | General Acute Care Hospital | Bldg. 851 289 Ireland Ave. Army Community Hospital, Fort Knox, KY 40121-5111 | 2007-02-16 |
| 1568561983 | Ireland Army Community Hospital | Military/U.S. Coast Guard Pharmacy | 410 Mitchell, Selfridge Air Base, MI 48045 | 2006-09-22 |
| Street Address |
1679 S 10TH AVE MCCOY OHC |
| City | FORT MCCOY |
| State | WI |
| Zip Code | 54656-5114 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669929279 | Jennifer Johnson | Physical Therapy Assistant | 14345 County Hwy B, Sparta, WI 54656 | 2016-09-01 |
| 1578019899 | M&t Performance Chiropractic, LLC | Chiropractor | 213 N Black River St, Sparta, WI 54656 | 2016-08-28 |
| 1801223003 | Emily M Nolte | Counselor | 112 S Court St. Room 3000, Sparta, WI 54656 | 2013-10-02 |
| 1518254945 | Therapeutic Home Services | Point of Service | 9484 Festival Avenue, Sparta, WI 54656 | 2011-07-06 |
| 1639488273 | Rebecca Ann Frey | Reflexologist | 5680 Canary Ave, Sparta, WI 54656 | 2010-09-30 |
| 1316276660 | Gary J Korthals | Pharmacist | 201 S. Water St, Sparta, WI 54656 | 2009-12-16 |
| 1689847329 | Donald N. La Force | Hearing Instrument Specialist | 117 West Oak St, Sparta, WI 54656 | 2008-04-02 |
| 1164400503 | Alice M Bachop | Nurse Practitioner | 310 West Main Street, Sparta, WI 54656 | 2006-01-05 |
| 1578540894 | Marc D Tumerman | Family Medicine | 310 West Main St, Sparta, WI 54656 | 2005-12-28 |
| 1003398488 | Ariel Dawn Ferdock | Pharmacist | 310 W Main St, Sparta, WI 54656 | 2018-09-03 |
| Find all providers in zip 54656 | ||||
| Taxonomy Code | 261QM1100X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Military/U.S. Coast Guard Outpatient |
| The Defense Health Program or U.S. Coast Guard funded "fixed" facilities or distinct parts of a facility, providing outpatient medical and dental services, primarily for Uniformed Services beneficiaries. A "fixed" facility is a non-temporary, non-deployed facility. It includes mobile specialty units such as Magnetic Resonance Imaging (MRI) units that may furnish services at the "fixed" facility. It includes, as examples, the institutional portion of outpatient encounters (except Ambulatory Procedure Visits), supplies issued (e.g., glasses, ostomy supplies, crutches), and radiology and laboratory studies. Does not include items issued directly to a patient from an outpatient pharmacy or patient transport. |
| Notes: Source: TRICARE Management Activity Uniform Business Office User’s Guide [1/1/2005: title modified, definition added; 7/1/2006 title modified, definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912155813 | Ireland Army Community Hospital | Clinic/Center | 2669 W Regimental Ave, Fort Mccoy, WI 54656-5229 | 2008-09-04 |
| 1093910481 | Ireland Army Community Hospital | Clinic/Center | 2669 W Regimental Ave, Fort Mccoy, WI 54656-5229 | 2007-06-18 |
| 1265647705 | Ireland Army Community Hospital | Clinic/Center | 2669 W Regimental Ave, Bldg 2669, Fort Mccoy, WI 54656-5229 | 2007-05-10 |
| City | FORT MCCOY |
| Zip Code | 54656 |
Please comment or provide details below to improve the information on IRELAND 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.