GUTHRIE AHC (NPI# 1962823575) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962823575 |
| Entity Type | Organization |
| Organization Name | GUTHRIE AHC |
| Other Organization Name | EBH 3RD BCT CLINIC-DRUM |
| Practice Address |
11050 Mount Beledere Blvd Fort Drum NY 13602 |
| Mailing Address |
11050 Mount Belvedere Blvd C/o Ubo Fort Drum NY 13602-5438 |
| Practice Telephone | 3157720977 |
| Mailing Telephone | 3157724033 |
| Enumeration Date | 2013-12-27 |
| Last Update Date | 2015-04-20 |
| Authorized Official Name | NANCY DRAPER (ACTING UBO MANAGER) |
| Authorized Official Telephone | 3157721755 |
| Is Organization Subpart | Y |
| Parent Organization Name | GUTHRIE AHC |
| 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 |
| Other Name | Type Code |
|---|---|
| EBH 3rd BCT CLINIC-DRUM | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063902666 | Guthrie Ahc | Clinic/Center | P19914 M3r Tampa, Fort Drum, NY 13602 | 2018-05-18 |
| 1548681240 | Guthrie Ahc | Clinic/Center | 5th Armored Division Drive, Fort Drum, NY 13602 | 2013-12-23 |
| 1811192594 | Guthrie Ahc | Clinic/Center | 10720 Mt Belvedere Blvd, Suite A1-102, Fort Drum, NY 13602-5040 | 2007-06-20 |
| 1215091962 | Guthrie Ahc | Military/U.S. Coast Guard Pharmacy | Usa Meddhc 11050 Mt Belvedere Blvd, Ft Drum, NY 13601 | 2006-12-20 |
| 1336248798 | Guthrie Ahc | Military/U.S. Coast Guard Pharmacy | P10506 Second St, Ft Drum, NY 13602 | 2006-09-22 |
| 1881793255 | Guthrie Ahc | Military/U.S. Coast Guard Pharmacy | Munns Corners Rd P2065, Ft Drum, NY 13602 | 2006-09-22 |
| 1366863060 | Guthrie Ahc | Clinic/Center | 4th Armored Division Drive, Fort Drum, NY 13602 | 2013-12-23 |
| 1144565797 | Guthrie Ahc | Clinic/Center | 40 Franklin St, Carthage, NY 13619-1377 | 2012-12-10 |
| 1780950030 | Guthrie Ahc | Military/U.S. Coast Guard Pharmacy | 11050 Mount Belvedere Blvd, Fort Drum, NY 13602-5438 | 2012-03-30 |
| 1740486091 | Guthrie Ahc | Clinic/Center | 10590 Enduring Freedom Drive, Fort Drum, NY 13602 | 2007-06-25 |
| Street Address |
11050 MOUNT BELEDERE BLVD |
| City | FORT DRUM |
| State | NY |
| Zip Code | 13602 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235697590 | Joshua Lee Hickman | Physician Assistant | Bldg P10506 Euphrates River Valley Rd, Fort Drum, NY 13602 | 2019-03-06 |
| 1447721345 | Lisa Marie Lewis | Social Worker | 11044 Mount Belvedere Blvd, Fort Drum, NY 13602 | 2018-12-17 |
| 1720555253 | Elizabeth M Hover | Social Worker | P11050 Mt Belvedere Blvd, Fort Drum, NY 13602 | 2018-11-02 |
| 1376037424 | Phillip Dakotah Mitchell | Physician Assistant | 10020 Euphrates River Valley Road, Fort Drum, NY 13602 | 2018-06-20 |
| 1063902666 | Guthrie Ahc | Clinic/Center | P19914 M3r Tampa, Fort Drum, NY 13602 | 2018-05-18 |
| 1255846879 | Morgan Elizabeth Callari | Dental Hygienist | 10205 S Riva Ridge Loop, Fort Drum, NY 13602 | 2017-12-05 |
| 1609389097 | John Charles Bockmann | Physician Assistant | Connor Troop Medical Clinic, 10506 Euphrates River Valley Rd, Fort Drum, NY 13602 | 2017-11-08 |
| 1902318207 | Nicholas Andrew Jones | Military Health Care Provider | 10506 S. Riva Ridge, Fort Drum, NY 13602 | 2017-10-26 |
| 1508389198 | Richard Scott Christiansen | Physical Therapist | 10330 S Riva Ridge Loop, Fort Drum, NY 13602 | 2017-07-25 |
| 1811418098 | Emer B Bajuelos | Dentist | Ft Drum W07uaa 10590, Ft Drum, Apo, AP 13602 | 2017-06-28 |
| Find all providers in zip 13602 | ||||
| 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 |
|---|---|---|---|---|
| 1063902666 | Guthrie Ahc | Clinic/Center | P19914 M3r Tampa, Fort Drum, NY 13602 | 2018-05-18 |
| 1548681240 | Guthrie Ahc | Clinic/Center | 5th Armored Division Drive, Fort Drum, NY 13602 | 2013-12-23 |
| 1811192594 | Guthrie Ahc | Clinic/Center | 10720 Mt Belvedere Blvd, Suite A1-102, Fort Drum, NY 13602-5040 | 2007-06-20 |
| 1366863060 | Guthrie Ahc | Clinic/Center | 4th Armored Division Drive, Fort Drum, NY 13602 | 2013-12-23 |
| 1740486091 | Guthrie Ahc | Clinic/Center | 10590 Enduring Freedom Drive, Fort Drum, NY 13602 | 2007-06-25 |
| 1457556136 | Guthrie Ahc | Clinic/Center | 10205 N Riva Ridge Loop, Suite P10205, Fort Drum, NY 13602-5457 | 2007-06-20 |
| 1093920811 | Guthrie Ahc | Clinic/Center | 10205 N Riva Ridge Loop, Suite P10506, Fort Drum, NY 13602-5457 | 2007-05-14 |
| 1164637112 | Guthrie Ahc | Clinic/Center | 10205 N Riva Ridge Loop, Suite P36, Fort Drum, NY 13602-5457 | 2007-05-13 |
| 1730247156 | Guthrie Ahc | Clinic/Center | 11050 Mount Belvedere Blvd, Ubo, Fort Drum, NY 13602-5438 | 2006-12-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750578977 | Branch Medical Clinic Saratoga Springs | Clinic/Center | 1 West Ave Ste 2, Saratoga Springs, NY 12866-6045 | 2007-10-02 |
| 1235334392 | Keller Army Community Hospital | Clinic/Center | 606 Cullum Road, Building 606, West Point, NY 10996 | 2007-06-19 |
| 1770553752 | Uscg Sector New York | Clinic/Center | 215 Drum Road, Room D-113, Staten Island, NY 10305 | 2006-01-24 |
| 1144565797 | Guthrie Ahc | Clinic/Center | 40 Franklin St, Carthage, NY 13619-1377 | 2012-12-10 |
| 1881899987 | Keller Army Community Hospital | Clinic/Center | 900 Washington Rd, West Point, NY 10996-1109 | 2007-06-19 |
| 1205042017 | Keller Army Community Hospital | Clinic/Center | 900 Washington Rd, Bldg 606, West Point, NY 10996-1109 | 2007-05-16 |
| 1124234935 | Keller Army Community Hospital | Clinic/Center | 900 Washington Rd, Bldg 606, West Point, NY 10996-1109 | 2007-05-16 |
| 1134333883 | Keller Army Community Hospital | Clinic/Center | 114 White Ave, Fort Hamilton, NY 11252-9503 | 2007-05-10 |
| 1285774752 | Uscg Sector New York Medical | Clinic/Center | 215 Drum Rd Rm D113, Staten Island, NY 10305-5001 | 2007-02-07 |
| 1033204391 | Uscg Sector Ny Clinic | Clinic/Center | 215 Drum Rd, Rm D-113, Staten Island, NY 10305-5001 | 2006-10-04 |
| 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.