WOMACK ARMY MEDICAL CENTER (NPI# 1891246708) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1891246708 |
| Entity Type | Organization |
| Organization Name | WOMACK ARMY MEDICAL CENTER |
| Other Organization Name | BRAGG WOMACK ANNEX PHCY |
| Practice Address |
1571 Reilly Rd Bldg 4 Ft Bragg NC 28307 |
| Mailing Address |
Womack Army Medical Center 2817 Reilly Rd Attn: Mcxc-dbo-ub Wamc Stop A Fort Bragg NC 28310-7394 |
| Practice Telephone | 9109077427 |
| Practice Fax Number | 9109078506 |
| Mailing Telephone | 9109077427 |
| Enumeration Date | 2016-10-17 |
| Last Update Date | 2016-11-30 |
| 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 | 333600000X | Pharmacy | Suppliers | ||
| Y | 332000000X | Military/U.S. Coast Guard Pharmacy | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PK | 2164687 | 01 |
| Other Name | Type Code |
|---|---|
| BRAGG WOMACK ANNEX PHCY | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356907471 | Womack Army Medical Center | Military/U.S. Coast Guard Pharmacy | 4-2817 Reilly Rd Bldg B, Fort Bragg, NC 28310-0001 | 2019-05-14 |
| 1861867293 | Womack Army Medical Center | Military Hospital | 2817 Reily Road, Fort Bragg, NC 28317 | 2015-12-10 |
| 1700250248 | Womack Army Medical Center | Rehabilitation Unit | 215 Ice Ave, 100, Dayton, OH 45402 | 2015-11-20 |
| 1205206935 | Womack Army Medical Center | Clinic/Center | 3908 Longstreet, Bldg 3-4303, Fort Bragg, NC 28310-0001 | 2015-10-07 |
| 1932577368 | Womack Army Medical Center | Military/U.S. Coast Guard Pharmacy | 55 Centennial Pkwy, Cameron, NC 28326-4013 | 2015-09-02 |
| 1578951042 | Womack Army Medical Center | Clinic/Center | 55 Centennial Parkway, Cameron, NC 28326 | 2015-01-06 |
| 1801215660 | Womack Army Medical Center | Clinic/Center | 2857 Watson St, Bldg M-1704, Fort Bragg, NC 28310-0001 | 2014-04-09 |
| 1710306576 | Womack Army Medical Center | Clinic/Center | Tagaytay Rd Bldg C-1624, Fort Bragg, NC 28310-7301 | 2014-04-09 |
| 1508285362 | Womack Army Medical Center | Clinic/Center | Kendenburg St Bldg H-6338, Fort Bragg, NC 28310-0001 | 2014-04-09 |
| 1134433402 | Womack Army Medical Center | Clinic/Center | 2356 South Peak Drive, Hope Mills, NC 28348 | 2010-07-29 |
| Street Address |
1571 REILLY RD BLDG 4 |
| City | FT BRAGG |
| State | NC |
| Zip Code | 28307 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700498631 | Jaclyn Jennifer Willis | Dentist | Ardennes Street, Fort Bragg, NC 28307 | 2020-08-21 |
| 1003398850 | Bailey Moorhead | Dentist | Bldg C-6238 Ardennes Road, Fort Bragg, NC 28307 | 2018-08-29 |
| 1619454980 | Seth David Williams | Physician Assistant | Bldg C-1722 Tagatay Dr, Fort Bragg, NC 28307 | 2018-07-19 |
| 1134633894 | Ashley Andrick | Physician Assistant | 1722 Tagatay Dr, Fort Bragg, NC 28307 | 2017-11-16 |
| 1184144479 | Thomas William Hanna IIi | Dentist | Bldg C-6238 Ardennes St., Fort Bragg, NC 28307 | 2017-06-27 |
| 1720530355 | Robert Holly | Military Health Care Provider | 7606 Reilly Rd, Bldg 2, Fort Bragg, NC 28307 | 2016-10-31 |
| 1710319405 | Valerie D. Jefferys | Pharmacist | 2817 Reily Road Womack Army Medical Center, Apo, AE 28307 | 2013-08-05 |
| 1689976367 | Komkwuan Pholtavee Paruchabutr | Registered Nurse | Building 4-2817 Reilly Road, Fort Bragg, NC 28307 | 2010-12-01 |
| 1609032879 | Kristi Lyn Natalino | Physical Therapist | 2817 Reilly Rd Bldg 4, Physical Therapy Department, Fort Bragg, NC 28307 | 2008-08-06 |
| 1841465051 | Mary Thomas Plunkett | Internal Medicine | Building 4-2817 Reilly Road Womack Army Medical Center, Internal Medicine Dept - Fort Bragg, Fayetteville, NC 28307 | 2008-04-29 |
| Find all providers in zip 28307 | ||||
| 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 |
|---|---|---|---|---|
| 1356907471 | Womack Army Medical Center | Military/U.S. Coast Guard Pharmacy | 4-2817 Reilly Rd Bldg B, Fort Bragg, NC 28310-0001 | 2019-05-14 |
| 1932577368 | Womack Army Medical Center | Military/U.S. Coast Guard Pharmacy | 55 Centennial Pkwy, Cameron, NC 28326-4013 | 2015-09-02 |
| 1427435585 | Naval Medical Center Camp Lejeune | Military/U.S. Coast Guard Pharmacy | Stone St. Extention, Bldg Nh200, Camp Lejeune, NC 28547 | 2015-04-28 |
| 1104238724 | Naval Health Clinic Cherry Point | Military/U.S. Coast Guard Pharmacy | Naval Health Clinic Cherry Point, Building 4389, Beaufort Rd, Mcas Cherry Point, NC 28533-0023 | 2014-06-02 |
| 1821400516 | Naval Medical Center Camp Lejeune | Military/U.S. Coast Guard Pharmacy | Brewster Blvd Bldg Nh100, Usn-naval Hospital, Camp Lejeune, NC 28547-0100 | 2014-05-29 |
| 1710252499 | Naval Medical Center Camp Lejeune | Military/U.S. Coast Guard Pharmacy | A Street, Bldg # Rr 440, Camp Lejeune, NC 28542-0117 | 2012-03-14 |
| 1447359732 | Womack Army Medical Center | Military/U.S. Coast Guard Pharmacy | Lane Rd Bldg M4861, Fort Bragg, NC 28310-0001 | 2006-09-22 |
| 1538268826 | Womack Army Medical Center | Military/U.S. Coast Guard Pharmacy | Butner Rd Bldg 85050, Fort Bragg, NC 28310-0001 | 2006-09-22 |
| 1093814386 | Womack Army Medical Center | Military/U.S. Coast Guard Pharmacy | Gruber Rd Bldg C1722, Fort Bragg, NC 28310-0001 | 2006-09-22 |
| 1215036546 | Naval Health Clinic Cherry Point | Military/U.S. Coast Guard Pharmacy | Bldg 4389 Beaufort St, Cherry Point, NC 28533-0023 | 2006-09-22 |
| Find all providers with the same taxonomy | ||||
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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.