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).
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 |
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 |
---|---|
USADC EDGEWOOD ARSENAL | Doing Business As Name - Organization |
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 |
Street Address |
4110 AUSTIN ROAD |
City | ABERDEEN PROVING GROUND |
State | MD |
Zip Code | 21010 |
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 |
Find all providers in zip 21010 |
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 |
---|---|---|---|---|
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 |
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 |
City | ABERDEEN PROVING GROUND |
Zip Code | 21010 |
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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.