WOMACK ARMY MEDICAL CENTER (NPI# 1912204405) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912204405 |
| Entity Type | Organization |
| Organization Name | WOMACK ARMY MEDICAL CENTER |
| Other Organization Name | BRAGG CBPCC FV PHCY |
| Practice Address |
2350 Bentridge Ln Fayetteville NC 28304-0590 |
| Mailing Address |
Womack Army Medicalcenter 2817 Reilly Rd Fort Bragg NC 28310-7394 |
| Practice Telephone | 9109089663 |
| Mailing Telephone | 9109076693 |
| Enumeration Date | 2011-02-17 |
| Last Update Date | 2015-05-29 |
| 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 |
|---|---|---|---|---|---|
| Y | 332000000X | Military/U.S. Coast Guard Pharmacy | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PK | 2128928 | 01 |
| Other Name | Type Code |
|---|---|
| BRAGG CBPCC FV 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 |
| 1891246708 | Womack Army Medical Center | Pharmacy | 1571 Reilly Rd, Bldg 4, Ft Bragg, NC 28307 | 2016-10-17 |
| 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 |
| Street Address |
2350 BENTRIDGE LN |
| City | FAYETTEVILLE |
| State | NC |
| Zip Code | 28304-0590 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760795769 | Womack Army Medical Center | Clinic/Center | 2350 Bentridge Ln, Woodland Bldg, Fayetteville, NC 28304-0586 | 2010-07-19 |
| 1790238335 | Living Well Behavioral Health, Inc. | Psychiatry & Neurology | 2350 Bentridge Ln, Suite 300, Fayetteville, NC 28304-0590 | 2016-08-01 |
| 1770944191 | Megan Frank | Nurse Practitioner | 2350 Bentridge Ln, Fayetteville, NC 28304-0590 | 2016-03-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598301061 | Coast To Coast Bilingual Counseling | Social Worker | 910 Hope Mills Road, Fayetteville, NC 28304 | 2019-11-20 |
| 1811530561 | Frances L. Hurst | Technician | 6732 Carloway Dr, Fayetteville, NC 28304 | 2019-10-25 |
| 1538717764 | Rose Mary A O'conner | Technician | 3530 Madison Ave, Fayetteville, NC 28304 | 2019-08-30 |
| 1932756087 | Sally Frances Jones | Technician | 2053 Mango Circle, Fayetteville, NC 28304 | 2019-08-23 |
| 1326528803 | Jeneen Yvette Townsend | Counselor | 2671 Adams Lake Dr Apt F, Fayetteville, NC 28304 | 2018-08-15 |
| 1780179580 | Ma Cornelia Villavicencio Leano | Nurse Practitioner | 3081 Stone Carriage Cir Apt Z, Fayetteville, NC 28304 | 2018-06-25 |
| 1861986267 | Pediatric After Hours Care of Fayetteville | Pediatrics | 556 Sandhurst Drive, Fayetteville, NC 28304 | 2018-06-19 |
| 1700386133 | Good Night Medical of Ohio, LLC | Durable Medical Equipment & Medical Supplies | 405 Owen Dr Ste 202, Fayetteville, NC 28304 | 2018-02-12 |
| 1003321365 | Valleygate Dental Surgery Center of Fayetteville, LLC | Dentist | 2038 Litho Place, Fayetteville, NC 28304 | 2017-12-08 |
| 1871004663 | The Salt Project | Marriage & Family Therapist | 1611-b Owen Dr., Fayetteville, NC 28304 | 2017-10-19 |
| Find all providers in zip 28304 | ||||
| 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 | ||||
| City | FAYETTEVILLE |
| Zip Code | 28304 |
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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.