USAFA 10TH MEDICAL GROUP/SGSBR (NPI# 1982010955) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1982010955 |
Entity Type | Organization |
Organization Name | USAFA 10TH MEDICAL GROUP/SGSBR |
Other Organization Name | DOD USAFA COMMUNITY EPHCY |
Practice Address |
8118 Park Dr Usaf Academy CO 80840-2397 |
Mailing Address |
Usafa 10th Medical Group/sgsbr 4102 Pinion Dr. Suite 100 Usaf Academy CO 80840 |
Practice Telephone | 7193339801 |
Practice Fax Number | 7193335694 |
Mailing Telephone | 7193330545 |
Mailing Fax Number | 7193330544 |
Enumeration Date | 2014-07-10 |
Last Update Date | 2016-01-22 |
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 | 2146772 | 01 |
Other Name | Type Code |
---|---|
DoD USAFA COMMUNITY ePhcy | Doing Business As Name - Organization |
Street Address |
8118 PARK DR |
City | USAF ACADEMY |
State | CO |
Zip Code | 80840-2397 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1114554011 | Christina Dang | Student in an Organized Health Care Education/Training Program | 4355-b Faculty Drive, Us Air Force Academy, CO 80840 | 2020-03-23 |
1053893123 | Glen William Myers | Dentist | 2355-b Faculty Dr, Usaf Academy, Colorado, Usafa, AA 80840 | 2018-09-05 |
1225374499 | National Vision Optical | Technician/Technologist | Bldg 5136, Community Center Dr., Us Air Force Academy, CO 80840 | 2012-12-17 |
1366758906 | Brett Michael Germain | Dentist | 2355-b Faculty Dr., Usaf Academy, CO 80840 | 2010-08-20 |
1518289115 | Renee Jean Cole | Military Health Care Provider | 4515 East Juniper Dr Unit A, Usaf Academy, CO 80840 | 2010-02-23 |
1063655140 | Gregory S. Brooks | Military Health Care Provider | 2355 Faculty Dr Suite 1n207, 10th Amds, Usafa, CO 80840 | 2009-04-20 |
1801092390 | Bryant Mcneill | Internal Medicine | 4102 Pinion 10mdg, Usaf Academy, CO 80840 | 2007-06-22 |
1447384383 | Francis Crosby Jr. | Physician Assistant | 4102 Pinon Drive, Usaf Academy, CO 80840 | 2007-03-15 |
1023115870 | Evans Army Community Hospital | Military/U.S. Coast Guard Pharmacy | Bldg 5136 Eagle Dr, Ste 102, Usaf Academy, CO 80840 | 2006-09-20 |
1669582722 | Scott Layle Carbaugh | Physician Assistant | 4102 Pinion Dirve, Usaf Academy, CO 80840 | 2006-08-30 |
Find all providers in zip 80840 |
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 |
---|---|---|---|---|
1841397692 | Evans Army Community Hospital | Military/U.S. Coast Guard Pharmacy | 8119 Park Dr, Usaf Academy, CO 80840-2397 | 2006-09-20 |
1023115870 | Evans Army Community Hospital | Military/U.S. Coast Guard Pharmacy | Bldg 5136 Eagle Dr, Ste 102, Usaf Academy, CO 80840 | 2006-09-20 |
1114024965 | Evans Army Community Hospital | Military/U.S. Coast Guard Pharmacy | 2355 Faculty Dr Ste 1n207, Usaf Academy, CO 80840-1805 | 2006-09-20 |
1639278344 | Evans Army Community Hospital | Military/U.S. Coast Guard Pharmacy | 4102 Pinion Dr Ste 100, Usaf Academy, CO 80840-2502 | 2006-09-21 |
1750488508 | 10th Medical Group Sgsl | Military/U.S. Coast Guard Pharmacy | 8119 Park Dr, Usaf Academy, CO 80840-2397 | 2006-09-20 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1285012922 | 21st Medical Group | Military/U.S. Coast Guard Pharmacy | 220 Falcon Pkwy Bldg 220, Colorado Springs, CO 80912-5005 | 2015-05-14 |
1265845036 | Military Treatment Facility | Military/U.S. Coast Guard Pharmacy | 13611 E. Colfax Ave., Buckley Afb, CO 80011-9547 | 2014-06-09 |
1861623936 | Evans Army Community Hospital | Military/U.S. Coast Guard Pharmacy | 3220 Union Blvd, Colorado Springs, CO 80907-4900 | 2009-08-06 |
1518173236 | Evans Army Community Hospital | Military/U.S. Coast Guard Pharmacy | 7490 Sutherland Circle, Robinson Family Medicine Clinic, Fort Carson, CO 80913-4603 | 2007-05-16 |
1164512497 | Evans Army Community Hospital | Military/U.S. Coast Guard Pharmacy | Evans Ach 7500 Cochrane Circle, Evans Army Community Hospital, Ft Carson, CO 80913-4603 | 2006-10-16 |
1679672380 | 21 Medical Group | Military/U.S. Coast Guard Pharmacy | 220 Falcon Pkwy, Schriever Afb, CO 80912-5005 | 2006-09-21 |
1518066273 | Evans Army Community Hospital | Military/U.S. Coast Guard Pharmacy | 6351 Wetzel Ave, Bldg 1525, Ft Carson, CO 80913-4188 | 2006-09-21 |
1114026820 | Evans Army Community Hospital | Military/U.S. Coast Guard Pharmacy | 7490 Southerland Circle, Robinson Clinic, Ft Carson, CO 80913 | 2006-09-21 |
1043319858 | Evans Army Community Hospital | Military/U.S. Coast Guard Pharmacy | 6911 Titus Blvd Bldg 2353, Ft Carson, CO 80913-4429 | 2006-09-21 |
1932206786 | 460th Medical Logistics Whs | Military/U.S. Coast Guard Pharmacy | 317 N Telluride St, Bldg 7, Buckley Afb, CO 80011-7809 | 2006-09-20 |
Find all providers with the same taxonomy |
City | USAF ACADEMY |
Zip Code | 80840 |
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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.