RAYMOND W BLISS ARMY HEALTH CENTER (NPI# 1114026150) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114026150 |
| Entity Type | Organization |
| Organization Name | RAYMOND W BLISS ARMY HEALTH CENTER |
| Other Organization Name | HUACHUCA MAIN PHCY |
| Practice Address |
2 W Bliss Army Health Ctr Bldg 45001 Ft Huachuca AZ 85613 |
| Mailing Address |
Raymond W Bliss Army Health Center Mcxj-rmd-msao 2240 E Winrow Ave Ft Huachuca AZ 85613-5080 |
| Practice Telephone | 5205332520 |
| Practice Fax Number | 5205330464 |
| Enumeration Date | 2006-09-22 |
| Last Update Date | 2015-06-18 |
| Authorized Official Name | HECTOR MORALES (CHIEF DHA PASS) |
| Authorized Official Telephone | 2105366690 |
| 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 | 1990527 | 01 |
| Other Name | Type Code |
|---|---|
| HUACHUCA MAIN PHCY | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710391156 | Raymond W Bliss Army Health Center | Military/U.S. Coast Guard Pharmacy | 2240 Winrow Rd Bldg 45001, Raymond W. Bliss Army Health Center, Fort Huachuca, AZ 85613-5080 | 2014-06-13 |
| 1619337995 | Raymond W Bliss Army Health Center | Clinic/Center | 2240 Winrow Ave, Fort Huachuca, AZ 85613-7079 | 2016-03-01 |
| 1558332080 | Raymond W Bliss Army Health Center | Clinic/Center | 2240 Winrow Rd, Ft Huachuca, AZ 85613-5080 | 2006-02-01 |
| Street Address |
2 W BLISS ARMY HEALTH CTR BLDG 45001 |
| City | FT HUACHUCA |
| State | AZ |
| Zip Code | 85613 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457713794 | Robert Lee Kent Jr. | Registered Nurse | 2240 East Winrow Avenue, Fort Huachuca, AZ 85613 | 2016-03-25 |
| 1548628662 | George Fauber | Licensed Practical Nurse | 224 Winrow Ave, Usa Meddac, Rwbahc, Ft Huachuca, AZ 85613 | 2016-02-03 |
| 1013207810 | Gerald Michael Pastore | Counselor | 2240 Winrow Ave Fort Huachuca, Az, Usa Meddac, Rwbahc, Apo, AA 85613 | 2011-04-13 |
| 1306049895 | Raymond W. Bliss Army Health Center | Clinic/Center | 45005 Arizona Street, Fort Huachuca, AZ 85613 | 2007-06-11 |
| 1477617124 | Raymond W. Bliss Army Health Center | Military/U.S. Coast Guard Pharmacy | 2w Bliss Army Health Center 45001, Ft Huachuca, AZ 85613 | 2006-12-20 |
| 1013931484 | Mark Allen Hendrickson | Internal Medicine | Rwbahc, Bldg 45001, Sierra Vista Cboc, Ft Huachuca, AZ 85613 | 2006-07-27 |
| 1972538973 | Gail Pielack | Nurse Practitioner | Rwbahc, 2240 Winrow Rd, Fort Huachuca, AZ 85613 | 2006-07-11 |
| 1093755233 | National Vision, Inc. | Eyewear Supplier (Equipment, not the service) | Optical Center, Bldg 52030, Ft. Huachuca, AZ 85613 | 2006-06-07 |
| 1336119395 | Eric Nmi Danko | Dentist | 2240 E. Winrow Ave, Us Army Dental Activity, Fort Huachuca, AZ 85613 | 2006-01-24 |
| 1245855410 | Kevin Matthew Farley | Dentist | 2240 E. Winrow Ave, Fort Huachuca, AZ 85613 | 2020-06-12 |
| Find all providers in zip 85613 | ||||
| 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 |
|---|---|---|---|---|
| 1477617124 | Raymond W. Bliss Army Health Center | Military/U.S. Coast Guard Pharmacy | 2w Bliss Army Health Center 45001, Ft Huachuca, AZ 85613 | 2006-12-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942697685 | Naval Hospital Camp Pendleton | Military/U.S. Coast Guard Pharmacy | Marine Corps Air Station, Bldg 1175, Yuma, AZ 85369 | 2015-04-21 |
| 1710391156 | Raymond W Bliss Army Health Center | Military/U.S. Coast Guard Pharmacy | 2240 Winrow Rd Bldg 45001, Raymond W. Bliss Army Health Center, Fort Huachuca, AZ 85613-5080 | 2014-06-13 |
| 1467864090 | Weed Army Community Hospital | Military/U.S. Coast Guard Pharmacy | 301 C St Bldg 990, Us Army Health Clinic,yuma Proving Ground, Ypg, AZ 85365-9498 | 2014-06-02 |
| 1972693208 | Yuma Flas Phcy | Military/U.S. Coast Guard Pharmacy | Bmc Bldg 1175, Yuma, AZ 85369-9116 | 2006-10-16 |
| 1427148758 | Naval Hospital Camp Pendleton | Military/U.S. Coast Guard Pharmacy | Bhc Marine Corp Air Station, Bldg 1175, Yuma, AZ 85369 | 2006-10-16 |
| 1306945472 | 56th Medical Group Sgsl | Military/U.S. Coast Guard Pharmacy | Bldg 810, Luke Afb, AZ 85309 | 2006-09-22 |
| 1396844338 | Weed Army Community Hospital | Military/U.S. Coast Guard Pharmacy | Bldg 990, Yuma, AZ 85365 | 2006-09-22 |
| 1205935244 | 355th Medical Group Sgsl | Military/U.S. Coast Guard Pharmacy | 2714 Bola Ave, Tucson, AZ 85707 | 2006-09-22 |
| 1699162339 | Naval Hospital Camp Pendleton | Military/U.S. Coast Guard Pharmacy | Bhc Marine Corp Air Station, Bldg 1175, Yuma, AZ 85369 | 2015-04-21 |
| 1043627631 | 56th Medical Group | Military/U.S. Coast Guard Pharmacy | 7219 N Litchfield Rd Bldg 1130, Luke Afb, AZ 85309-1529 | 2014-07-16 |
| Find all providers with the same taxonomy | ||||
| City | FT HUACHUCA |
| Zip Code | 85613 |
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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.