UNITED STATES ARMY AEROMEDICAL CENTER (NPI# 1982010351) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1982010351 |
| Entity Type | Organization |
| Organization Name | UNITED STATES ARMY AEROMEDICAL CENTER |
| Other Organization Name | DOD FT RUCKER EPHCY |
| Practice Address |
301 Andrews Avenue Fort Rucker AL 36362-5350 |
| Mailing Address |
United States Army Areomedical Center 301 Andrews Rd C/o Attn Mcxy-rm-tpcp Ft Rucker AL 36362 |
| Practice Telephone | 3342257181 |
| Practice Fax Number | 3342257176 |
| Mailing Telephone | 3342257181 |
| Mailing Fax Number | 3342257176 |
| Enumeration Date | 2014-07-07 |
| Last Update Date | 2015-06-25 |
| 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 | 2146669 | 01 |
| Other Name | Type Code |
|---|---|
| DoD FT RUCKER ePhcy | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144423617 | United States Army Aeromedical Center | Clinic/Center | 4405 Innkeeper Street, Fort Rucker, AL 36362 | 2007-06-11 |
| 1346349495 | United States Army Aeromedical Center | Military/U.S. Coast Guard Pharmacy | Dustoff Ave Bldg 301, Ft Rucker, AL 36362-5333 | 2006-09-22 |
| 1932122314 | United States Army Aeromedical Center | Clinic/Center | 301 Andrews Rd, Fort Rucker, AL 36362 | 2006-07-25 |
| 1558549121 | United States Army Aeromedical Center | Military/U.S. Coast Guard Pharmacy | 5th Ave, Bldg 4405, Ft. Rucker, AL 36362-5333 | 2008-02-06 |
| Street Address |
301 ANDREWS AVENUE |
| City | FORT RUCKER |
| State | AL |
| Zip Code | 36362-5350 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932107307 | James C. Dover | Optometrist | 301 Andrews Avenue, Lyster Army Health Clinic, Fort Rucker, AL 36362-5333 | 2005-07-11 |
| 1598376469 | Wesley Hendrick Mccormick | Psychologist | 301 Andrews Avenue, Fort Rucker, AL 36362 | 2020-08-13 |
| 1366936817 | Twanna Versel Johnson | Social Worker | 301 Andrews Avenue, Cavhcs (va Wiregrass Clinic), Fort Rucker, AL 36362 | 2018-06-19 |
| 1770096406 | Jose A Morejon | Emergency Medical Technician, Basic | 301 Andrews Avenue, Fort Rucker, AL 36362 | 2017-11-16 |
| 1013446723 | Christopher Warren Fleming | Pharmacist | 301 Andrews Avenue, Fort Rucker, AL 36362 | 2017-06-06 |
| 1497296701 | Cody Shedd | Emergency Medical Technician, Basic | 301 Andrews Avenue, Lyster Army Health Clinic, Fort Rucker, AL 36362-5333 | 2017-03-20 |
| 1760924583 | James Darren Beasley | Physical Therapy Assistant | 301 Andrews Avenue, Fort Rucker, AL 36360 | 2016-11-10 |
| 1538616768 | Deseree Moe | Emergency Medical Technician, Basic | 301 Andrews Avenue, Lyster Army Health Clinic, Fort Rucker, AL 36362-5333 | 2016-09-06 |
| 1093261232 | Kristin Henderson | Registered Nurse | 301 Andrews Avenue, Fort Rucker, AL 36362 | 2016-08-28 |
| 1942652490 | Evie Ehret | Occupational Therapist | 301 Andrews Avenue, Fort Rucker, AL 36362 | 2016-07-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235745571 | Rachel Kestler | Specialist | 4102 Gadiator Street, Fort Rucker, AL 36362 | 2020-09-22 |
| 1417589268 | Jacob Michael Lezon | Emergency Medical Technician, Basic | 30501 Nevins St., Ft. Rucker, AL 36362 | 2020-02-10 |
| 1225535388 | Rhonda Lewis Wesolek | Dental Hygienist | Bldg 4405, Innkeeper Street, Fort Rucker, AL 36362 | 2018-04-06 |
| 1770013369 | National Vision, Inc. | Technician/Technologist | Bldg 9214, Fort Rucker, AL 36362 | 2017-06-15 |
| 1750730958 | Teresa Morgan Knighten | Dental Hygienist | 4405 Innkeepers St, Fort Rucker, AL 36362 | 2016-06-08 |
| 1568826246 | David Virgil II | Technician, Other | 2218 6th Avenue Building 4102, Fort Rucker, AL 36362 | 2016-04-08 |
| 1356771257 | Robert E Smith | Emergency Medical Technician, Intermediate | Blding 301 Andrew Ave, Ft Rucker, AL 36362 | 2013-11-14 |
| 1548503469 | Lindsey Taylor Mendenhall | Emergency Medical Technician, Basic | Bldg 301 Andrews Ave 1-223rd Hhc, Lyster Army Health Clinic, Fort Rucker, AL 36362 | 2013-03-28 |
| 1689913808 | Sunland Optical Co., Inc. | Eyewear Supplier (Equipment, not the service) | Fort Rucker Bldg. 9214, Daleville, AL 36362 | 2013-02-07 |
| 1275880205 | Sandra Lynn Griffin Banner | Optometrist | 33 Endl Ave, Fort Rucker, AL 36362 | 2012-08-09 |
| Find all providers in zip 36362 | ||||
| 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 |
|---|---|---|---|---|
| 1346349495 | United States Army Aeromedical Center | Military/U.S. Coast Guard Pharmacy | Dustoff Ave Bldg 301, Ft Rucker, AL 36362-5333 | 2006-09-22 |
| 1487068201 | Fox Army Health Center | Military/U.S. Coast Guard Pharmacy | 4100 Goss Rd Sw, Fox Army Health Center, Huntsville, AL 35809-0001 | 2014-06-19 |
| 1558549121 | United States Army Aeromedical Center | Military/U.S. Coast Guard Pharmacy | 5th Ave, Bldg 4405, Ft. Rucker, AL 36362-5333 | 2008-02-06 |
| 1164521217 | Fox Army Health Center | Military/U.S. Coast Guard Pharmacy | Usa Meddac, Bldg 4100 Goss Rd, Redstone Arsenal, AL 35809-7000 | 2006-09-22 |
| City | FORT RUCKER |
| Zip Code | 36362 |
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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.