NAVAL HOSPITAL CAMP PENDLETON (NPI# 1740385095) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1740385095 |
| Entity Type | Organization |
| Organization Name | NAVAL HOSPITAL CAMP PENDLETON |
| Other Organization Name | PT HUENEME PHCY |
| Practice Address |
162 1st St Naval Medical Center Port Hueneme CA 93043 |
| Mailing Address |
Po Box 555191 Camp Pendleton CA 92055-5191 |
| Practice Telephone | 8059826411 |
| Practice Fax Number | 8059826095 |
| Mailing Telephone | 8059826411 |
| Mailing Fax Number | 8059826095 |
| Enumeration Date | 2006-09-13 |
| Last Update Date | 2018-05-25 |
| Authorized Official Name | MR. WILLIAM MICHAEL CONDON (NAVY MEDICINE UBO PROGRAM MANAGER) |
| Authorized Official Telephone | 2404013643 |
| Is Organization Subpart | Y |
| Parent Organization Name | NAVAL HOSPITAL CAMP PENDLETON |
| 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 | 2115743 | 01 |
| Other Name | Type Code |
|---|---|
| PT HUENEME PHCY | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952765125 | Naval Hospital Camp Pendleton | Military/U.S. Coast Guard Pharmacy | 135 Santa Margarita Rd, Camp Pendelton, CA 92055 | 2016-04-13 |
| 1821485152 | Naval Hospital Camp Pendleton | Military/U.S. Coast Guard Pharmacy | Hospital Camp Pendelton, 200 Mercy Circle, Camp Pendelton, CA 92055 | 2015-04-24 |
| 1942697685 | Naval Hospital Camp Pendleton | Military/U.S. Coast Guard Pharmacy | Marine Corps Air Station, Bldg 1175, Yuma, AZ 85369 | 2015-04-21 |
| 1790179455 | Naval Hospital Camp Pendleton | Clinic/Center | 41 Area Branch Medical Clinic, Bldg 414006, Camp Pendleton, CA 92055 | 2015-03-20 |
| 1275948143 | Naval Hospital Camp Pendleton | Military/U.S. Coast Guard Pharmacy | Basilone Road, Bldg 520450, Camp Pendleton, CA 92055 | 2014-06-30 |
| 1285048348 | Naval Hospital Camp Pendleton | Military/U.S. Coast Guard Pharmacy | 41 Area Las Flores Nelson, Bldg 414006, Camp Pendleton, CA 92055 | 2014-06-17 |
| 1205249042 | Naval Hospital Camp Pendleton | Military/U.S. Coast Guard Pharmacy | 13 Area Branch Medic, Bldg 13129 14th St, Camp Pendelton, CA 92055 | 2014-06-10 |
| 1972916740 | Naval Hospital Camp Pendleton | Pharmacy | 52 Area Branch Medical, 540450 Basilone Rd, Camp Pendelton, CA 92055 | 2014-06-09 |
| 1275946444 | Naval Hospital Camp Pendleton | Military/U.S. Coast Guard Pharmacy | Hq Regiment, 16th Street, Camp Pendelton, CA 92055 | 2014-06-05 |
| 1366855538 | Naval Hospital Camp Pendleton | Military/U.S. Coast Guard Pharmacy | Hq Reg 1 Mlg Ras, Bldg 14008, Camp Pendelton, CA 95008 | 2014-06-05 |
| Street Address |
162 1ST ST NAVAL MEDICAL CENTER |
| City | PORT HUENEME |
| State | CA |
| Zip Code | 93043 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477555464 | Amy Galin | Pediatrics | 162 1st St, Port Hueneme, CA 93043-4316 | 2005-08-10 |
| 1144867532 | Andrew Thanh Bui | Military Health Care Provider | 162 1st St, Port Hueneme, CA 93043-4316 | 2019-12-04 |
| 1144623448 | Piotor Juchniewicz | Military Health Care Provider | 162 1st St, Port Hueneme, CA 93043-4316 | 2014-09-30 |
| 1467798900 | Andrew Tyson Hammond | Military Health Care Provider | 162 1st St, Port Hueneme, CA 93043-4316 | 2013-01-02 |
| 1376816165 | Lamar Alan Hooper | Military Health Care Provider | 162 1st St, Port Hueneme, CA 93043-4316 | 2012-02-10 |
| 1962687004 | Naval Hospital | Military Hospital | 162 1st St, Port Hueneme, CA 93043-4316 | 2008-01-08 |
| 1962615484 | Sara Berhanu | Pediatrics | 162 1st St, Naval Ambulatory Clinic, Port Hueneme, CA 93043-4316 | 2007-05-08 |
| 1285695676 | Jesus P Cirino | Pharmacist | 162 1st St, Building 1402, Port Hueneme, CA 93043-4316 | 2006-03-28 |
| 1043270291 | Heidi Sarte | Pharmacist | 162 1st St, Port Hueneme, CA 93043-4316 | 2006-03-23 |
| 1144205246 | David Kenneth White | Dentist | 162 1st St, Port Hueneme, CA 93043-4316 | 2005-12-12 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558852921 | Ryan Kitchens | Military Health Care Provider | 4643 Dock Road Building 524, Port Hueneme, CA 93043 | 2018-05-22 |
| 1881952661 | Underwater Construction Team Two | Military/U.S. Coast Guard Transport | 4643 Dock Road Bldg 524, Underwater Construction Team Two, Port Hueneme, CA 93043 | 2012-04-30 |
| 1528037108 | Thomas A Colp | Optometrist | 162 First Street, Port Hueneme, CA 93043 | 2006-03-16 |
| 1033184874 | Erwin Lee Hoffman | Pediatrics | 162 First St, Port Hueneme Amulatory Clinic Navy Base, Port Hueneme, CA 93043 | 2006-02-22 |
| 1366412157 | William Malcolm Brown IIi | Family Medicine | 1436 Pacific Avenue, Port Hueneme, CA 93043 | 2006-01-24 |
| 1316334717 | Naval Hospital Camp Pendleton | Military/U.S. Coast Guard Pharmacy | 162 1st St Bldg 1402, Port Hueneme, CA 93043 | 2015-04-23 |
| 1033506431 | Naval Hospital Camp Pendleton | Military/U.S. Coast Guard Pharmacy | 162 1st St Bldg 1402, Port Hueneme, CA 93043 | 2015-04-23 |
| 1871828723 | Seth T. Secrease | Military Health Care Provider | Naval Clinic Port Hueneme, 162 1st St, Port Hueneme, CA 93043-0001 | 2009-10-09 |
| 1396930129 | Shawn Jeremy Kern | Military Health Care Provider | Underwater Construction Team 2 Medical, 4643 Dock Road Bldg 524, Port Hueneme, CA 93043-0001 | 2007-09-14 |
| 1376754242 | Joshua William Ross | Military Health Care Provider | Naval Ambulatory Care Clinic, 162 1st Street Building 1402, Port Hueneme, CA 93043-0001 | 2007-05-24 |
| Find all providers in zip 93043 | ||||
| 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 |
|---|---|---|---|---|
| 1316334717 | Naval Hospital Camp Pendleton | Military/U.S. Coast Guard Pharmacy | 162 1st St Bldg 1402, Port Hueneme, CA 93043 | 2015-04-23 |
| 1033506431 | Naval Hospital Camp Pendleton | Military/U.S. Coast Guard Pharmacy | 162 1st St Bldg 1402, Port Hueneme, CA 93043 | 2015-04-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952765125 | Naval Hospital Camp Pendleton | Military/U.S. Coast Guard Pharmacy | 135 Santa Margarita Rd, Camp Pendelton, CA 92055 | 2016-04-13 |
| 1821485152 | Naval Hospital Camp Pendleton | Military/U.S. Coast Guard Pharmacy | Hospital Camp Pendelton, 200 Mercy Circle, Camp Pendelton, CA 92055 | 2015-04-24 |
| 1275948143 | Naval Hospital Camp Pendleton | Military/U.S. Coast Guard Pharmacy | Basilone Road, Bldg 520450, Camp Pendleton, CA 92055 | 2014-06-30 |
| 1265846323 | Naval Medical Center San Diego | Military/U.S. Coast Guard Pharmacy | 34800 Bob Wilson Dr Ste 3, San Diego, CA 92134-1003 | 2014-06-17 |
| 1285048348 | Naval Hospital Camp Pendleton | Military/U.S. Coast Guard Pharmacy | 41 Area Las Flores Nelson, Bldg 414006, Camp Pendleton, CA 92055 | 2014-06-17 |
| 1205249042 | Naval Hospital Camp Pendleton | Military/U.S. Coast Guard Pharmacy | 13 Area Branch Medic, Bldg 13129 14th St, Camp Pendelton, CA 92055 | 2014-06-10 |
| 1275946444 | Naval Hospital Camp Pendleton | Military/U.S. Coast Guard Pharmacy | Hq Regiment, 16th Street, Camp Pendelton, CA 92055 | 2014-06-05 |
| 1366855538 | Naval Hospital Camp Pendleton | Military/U.S. Coast Guard Pharmacy | Hq Reg 1 Mlg Ras, Bldg 14008, Camp Pendelton, CA 95008 | 2014-06-05 |
| 1841603248 | Naval Hospital Camp Pendleton | Military/U.S. Coast Guard Pharmacy | Branch Medical Clinic Naf, Bldg 23, El Centro, CA 92055 | 2014-06-04 |
| 1043622681 | David S Grant Medical Center | Military/U.S. Coast Guard Pharmacy | 461 Skymaster Cir Rm 149, Travis Afb, CA 94535-1909 | 2014-06-02 |
| Find all providers with the same taxonomy | ||||
| City | PORT HUENEME |
| Zip Code | 93043 |
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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.