NAVAL HEALTH CLINIC ANNAPOLIS (NPI# 1174172183) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174172183 |
| Entity Type | Organization |
| Organization Name | NAVAL HEALTH CLINIC ANNAPOLIS |
| Practice Address |
17457 Caffee Rd Bldg 192 Dahlgren VA 22448-5120 |
| Practice Telephone | 5406533689 |
| Practice Fax Number | 5406530279 |
| Mailing Telephone | 5406533689 |
| Mailing Fax Number | 5406530279 |
| Enumeration Date | 2019-09-11 |
| Last Update Date | 2019-09-11 |
| Authorized Official Name | ROSEMARY GONZALEZ (MTF SUPPORT ANALYST) |
| Authorized Official Telephone | 2105366096 |
| Is Organization Subpart | Y |
| Parent Organization Name | NAVAL HEALTH CLINIC ANNAPOLIS |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332000000X | Military/U.S. Coast Guard Pharmacy | Suppliers |
| Other Name | Type Code |
|---|---|
| DoD DAHLGREN ePhcy | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184273195 | Naval Health Clinic Annapolis | Military/U.S. Coast Guard Pharmacy | 4141 W Wilson Rd Bldg 1600, Indian Head, MD 20640-5162 | 2019-09-11 |
| 1801339866 | Naval Health Clinic Annapolis | Pharmacy | 101 Blake Rd, Annapolis, MD 21402-1300 | 2016-11-23 |
| 1346349792 | Naval Health Clinic Annapolis | Military/U.S. Coast Guard Pharmacy | Bmc Bldg 39, Naval Engineering Station, Lakehurst, NJ 08733 | 2006-09-22 |
| 1649682162 | Naval Health Clinic Annapolis | Military/U.S. Coast Guard Pharmacy | 695 Kinkaid Rd, Naval Health Clinic Annapolis, Annapolis, MD 21402 | 2014-06-02 |
| 1942309364 | Naval Health Clinic Annapolis | Military/U.S. Coast Guard Pharmacy | 250 Wood Rd, Annapolis, MD 21402-1257 | 2006-09-22 |
| 1528013414 | Naval Health Clinic Annapolis | Clinic/Center | 250 Wood Rd, Annapolis, MD 21402-1257 | 2006-05-23 |
| Street Address |
17457 CAFFEE RD BLDG 192 |
| City | DAHLGREN |
| State | VA |
| Zip Code | 22448-5120 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093000168 | Wal-mart Stores East Lp | Technician/Technologist | 16375 Merchant Lane, King George, VA 22448 | 2011-06-16 |
| 1720048408 | Christine Louise Manning | Military Health Care Provider | 192 Caffee Rd., Bhc Dahlgren, Dahlgren, VA 22448 | 2006-03-25 |
| 1093789364 | Lisa A Duggan | Physician Assistant | 16463 Dahlgren Rd, Dahlgren, VA 22448 | 2006-02-14 |
| 1043252802 | King George Medical Center Ltd | Pediatrics | 16463 Dahlgren Rd, Dahlgren, VA 22448 | 2006-06-12 |
| 1316305055 | Naomi Boley | Driver | 763 Caffee Rd, Dahlgren, VA 22448-3030 | 2016-02-09 |
| 1447457197 | Branch Medical Clinic Dahlgren | Clinic/Center | 192 Cassee Road, Bldg 192, Dahlgren, VA 22448-5000 | 2007-06-27 |
| 1497135073 | Rebecca Elizabeth Choi | Family Medicine | 17457 Caffee Rd, Dahlgren, VA 22448-5120 | 2015-06-09 |
| 1811283211 | Richard Alan Pierson | Family Medicine | 17457 Caffee Rd Ste 204, Dahlgren, VA 22448-5120 | 2011-06-23 |
| 1336634831 | Leonard Abadam | Physician Assistant | 17457 Caffee Rd Ste 204, Dahlgren, VA 22448-5120 | 2018-06-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679197958 | Sarah Michelle Milligan | Registered Nurse | 18033 County Road 500 E, Dahlgren, IL 62828-4294 | 2020-06-03 |
| 1548772270 | Jennifer Lea Tolley | Speech-Language Pathologist | 409 West Dale Street, Dahlgren, IL 62810 | 2017-11-03 |
| 1316305055 | Naomi Boley | Driver | 763 Caffee Rd, Dahlgren, VA 22448-3030 | 2016-02-09 |
| 1447457197 | Branch Medical Clinic Dahlgren | Clinic/Center | 192 Cassee Road, Bldg 192, Dahlgren, VA 22448-5000 | 2007-06-27 |
| 1003915133 | Naval Health Clinic Patuxent River | Military/U.S. Coast Guard Pharmacy | Branch Medical Clinic Bldg 192, Dahlgren, VA 22428 | 2006-09-22 |
| 1720048408 | Christine Louise Manning | Military Health Care Provider | 192 Caffee Rd., Bhc Dahlgren, Dahlgren, VA 22448 | 2006-03-25 |
| 1093789364 | Lisa A Duggan | Physician Assistant | 16463 Dahlgren Rd, Dahlgren, VA 22448 | 2006-02-14 |
| 1083046619 | Jennifer Maureen Irvin | Speech-Language Pathologist | Rr 1 Box 46, Dahlgren, IL 62828-9715 | 2013-08-06 |
| 1043252802 | King George Medical Center Ltd | Pediatrics | 16463 Dahlgren Rd, Dahlgren, VA 22448 | 2006-06-12 |
| 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 |
|---|---|---|---|---|
| 1003915133 | Naval Health Clinic Patuxent River | Military/U.S. Coast Guard Pharmacy | Branch Medical Clinic Bldg 192, Dahlgren, VA 22428 | 2006-09-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114403961 | Naval Medical Center Portsmouth | Military/U.S. Coast Guard Pharmacy | 7021 Harbor View Blvd, Suffolk, VA 23435-2869 | 2018-07-16 |
| 1437563269 | Fort Belvoir Community Hospital | Military/U.S. Coast Guard Pharmacy | 8651 John J Kingman Rd, Fort Belvoir Community Hospital, Fort Belvoir, VA 22060-6200 | 2014-06-19 |
| 1508270950 | Naval Medical Center Portsmouth | Military/U.S. Coast Guard Pharmacy | 1011 Eden Way N Ste H, Chesapeake, VA 23320-2768 | 2014-06-13 |
| 1205249059 | Naval Medical Center Portsmouth | Military/U.S. Coast Guard Pharmacy | 1647 Admiral Taussig Blvd Bldg Cd2, Norfolk, VA 23511-2803 | 2014-06-10 |
| 1467680819 | World Class Marketing Inc | Military/U.S. Coast Guard Pharmacy | 1814 Kecoughtan Rd, Suite B, Hampton, VA 23661-2834 | 2009-06-24 |
| 1609966936 | Naval Medical Center Portsmouth | Military/U.S. Coast Guard Pharmacy | Naval Weapons Station Yorktown, Bldg 1806, Yorktown, VA 23691-0090 | 2006-10-16 |
| 1982703013 | Kenner Army Health Clinic | Military/U.S. Coast Guard Pharmacy | Bldg 3219, Ft Lee, VA 23801 | 2006-09-22 |
| 1922107044 | Kenner Army Health Clinic | Military/U.S. Coast Guard Pharmacy | Bldg P8130, Ft Lee, VA 23801 | 2006-09-22 |
| 1659470771 | 1st Medical Group Sgsl | Military/U.S. Coast Guard Pharmacy | 65 Spaatz Dr, Langley Afb, VA 23665-2027 | 2006-09-22 |
| 1740389865 | Naval Medical Center Portsmouth | Military/U.S. Coast Guard Pharmacy | 1185 Terrier Ave, Ste 100, Virginia Beach, VA 23461 | 2006-09-22 |
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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.