KIMBROUGH ACC MILITARY MTF


Address: 4110 Austin Road, Aberdeen Proving Ground, MD 21010
Phone: 4102781824

KIMBROUGH ACC MILITARY MTF (NPI# 1093910374) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1093910374
Entity Type Organization
Organization Name KIMBROUGH ACC MILITARY MTF
Other Organization Name USADC EDGEWOOD ARSENAL
Practice Address 4110 Austin Road
Aberdeen Proving Ground
MD 21010
Mailing Address 2480 Llewellyn Ave
Cdr Usameddac Mcxr-bd Ste 5800
Fort Meade
MD 20755-7081
Practice Telephone 4102781824
Mailing Telephone 3016778253
Enumeration Date 2007-06-18
Last Update Date 2012-12-18
Authorized Official Name TERRI KIMBROW (UBO MANAGER)
Authorized Official Telephone 3016778512
Is Organization Subpart Y
Parent Organization Name KIMBROUGH ACC MILITARY MTF

Taxonomy

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 Provider/Organization Names

Other Name Type Code
USADC EDGEWOOD ARSENAL Doing Business As Name - Organization

Other Provider IDs and Locations

NPI Name Taxonomy Address Enumeration
1639667736 Kimbrough Acc Military Mtf Pharmacy G-avenue, Bldg 400 Dept of Pharmacy, New Cumberland, PA 17070 2018-04-25
1457849556 Kimbrough Acc Military Mtf Pharmacy Ft Indiantown Gap, Bldg 4-114, Annville, PA 17003 2018-04-25
1801206685 Kimbrough Acc Military Mtf Pharmacy 2799 Rose Street, Ft Meade, MD 20755 2014-05-02
1871709576 Kimbrough Acc Military Mtf Clinic/Center 99 G Street, Bldg 400, New Cumberland, PA 17070 2007-05-16
1417163114 Kimbrough Acc Military Mtf Clinic/Center 1999 Fisher Ave, Fort Indiantown Gap, Annville, PA 17003 2007-05-16
1235345935 Kimbrough Acc Military Mtf Clinic/Center Letterkenny Army Depot, Bldg 332, Chambersburg, PA 17201 2007-05-16
1689888455 Kimbrough Acc Military Mtf Military/U.S. Coast Guard Pharmacy 103 3rd Ave, Building 58, Washington, DC 20319-5058 2007-05-10
1992108633 Kimbrough Acc Military Mtf Military/U.S. Coast Guard Pharmacy 450 Gibner Rd, Carlisle, PA 17013-5090 2014-10-08
1205242310 Kimbrough Acc Military Mtf Military/U.S. Coast Guard Pharmacy 1434 Porter St, Frederick, MD 21702-9254 2014-07-09
1316353782 Kimbrough Acc Military Mtf Pharmacy 401 Carpenter Rd Bldg 525, Fort Myer, VA 22211-1009 2014-07-07

Office Location

Street Address 4110 AUSTIN ROAD
City ABERDEEN PROVING GROUND
State MD
Zip Code 21010

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1144481128 Joseph S. Jones Preventive Medicine Army Public Health Command, 5158 Black Hawk Rd, Gunpowder, MD 21010 2008-06-23
1649214735 John Hill Barker Jr. Dentist Bldg. E4110, Austin Road, Edgewood Dental Clinic, Apg Edgewood Area, MD 21010 2006-06-16
1770686636 James Malcolm Madsen Pathology 3100 Ricketts Point Rd, Usamricd, Attn: Mcmr-cdm (col Madsen), Gunpowder, MD 21010-5400 2006-09-06
1063572501 Charles Gary Hurst Dermatology 3100 Ricketts Point Rd, Gunpowder, MD 21010-5400 2006-12-12
1013064666 Sally Siefert Hoedebecke Dietitian, Registered 5158 Black Hawk Rd Bldg E1930, Aberdeen Proving Ground, MD 21010-5403 2007-01-05
1578543062 Michael Duane Pattison Optometrist Tsvcrd, Aphc, Attn: Mchb-ph-vcr, 8252 Blackhawk Road, Aberdeen Proving Ground, MD 21010-5403 2006-01-19
1528059037 Kimberly Ann Beck Preventive Medicine 5158 Black Hawk Rd, E1570, Gunpowder, MD 21010-5403 2005-11-03
1467978932 Kim Theresa Pierre Audiologist 5158 Black Hawk Rd, Aberdeen Proving Ground, MD 21010-5403 2017-08-16
1144552514 Roger Gregory Mcintosh Preventive Medicine 5158 Black Hawk Rd, Bldg E-1570, Gunpowder, MD 21010-5403 2010-02-09
1457408379 Deanna Harkins Preventive Medicine 5158 Black Hawk Rd, E1570, Gunpowder, MD 21010-5403 2007-01-04
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Taxonomy Information

Taxonomy Code 261QM1100X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Military/U.S. Coast Guard Outpatient

Taxonomy Definition

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]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1689879926 Kimbrough Acc Military Mtf Clinic/Center 2501 Oakington St, Aberdeen Proving Ground, MD 21005-5131 2007-06-18
1073729745 Kimbrough Acc Military Mtf Clinic/Center 2501 Oakington St, Building E-4110, Aberdeen Proving Ground, MD 21005-5131 2007-05-16
1508072281 Kimbrough Acc Military Mtf Clinic/Center 2501 Oakington St, Aberdeen Proving Ground, MD 21005-5131 2007-05-16

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1841498417 Branch Medical Clinic Indian Head Clinic/Center 4141 W Wilson Rd, Suite105, Indian Head, MD 20640-5162 2007-07-05
1033315080 Branch Medical Clinic Bancroft Hall Clinic/Center 121 Blake Rd, Annapolis, MD 21402-1300 2007-06-26
1063959450 Uscg Clinic Baltimore Clinic/Center 2401 Hawkins Point Rd, Curtis Bay, MD 21226-1797 2017-01-24
1043668775 Logistics Health Incorporated Clinic/Center 4201 Northview Dr Ste 410, Bowie, MD 20716-2668 2016-06-03
1811228422 Us Coast Guard Clinic/Center 2401 Hawkins Point Rd, Baltimore, MD 21226-1797 2010-01-21
1851622401 Us Coast Guard Yard - Hswl Clinic Clinic/Center 2401 Hawkins Point Rd, Bldg 28b, Baltimore, MD 21226 2010-01-21
1487850541 Branch Medical Clinic Andrews Clinic/Center 1 San Diego Loop, Bldg 3282, Andrews Afb, MD 20762-5518 2007-06-26
1316142607 Kimbrough Acc Military Mtf Clinic/Center 1434 Porter St, Usadc, Fort Detrick, MD 21702-9210 2007-06-18
1124223797 Kimbrough Acc Military Mtf Clinic/Center 8472 Simmond St, Fort Meade, MD 20755-5700 2007-06-15
1558566125 Kimbrough Acc Military Mtf Clinic/Center 2480 Llewellyn Ave, Usadc-3, Fort Meade, MD 20755-5800 2007-06-15
Find all providers with the same taxonomy

Competitor

Search similar providers

City ABERDEEN PROVING GROUND
Zip Code 21010

Improve Information

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Dataset Information

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.

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