LANDRU DEREK MEDVEC


Address: 2422 Arctic Ave, Apt D, Eielson Afb, AK 99702
Phone: 9073724458

LANDRU DEREK MEDVEC (NPI# 1225272073) 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) 1225272073
Entity Type Individual
Full Name LANDRU DEREK MEDVEC
Credential IDMT
Practice Address 2422 Arctic Ave
Apt D
Eielson Afb
AK 99702
Mailing Address 2630 Central Ave
Suite 1m07
Eielson Afb
AK 99702-2301
Practice Telephone 9073724458
Practice Fax Number 9073724458
Mailing Telephone 9073776526
Mailing Fax Number 9073772763
Enumeration Date 2009-04-23
Last Update Date 2009-04-23
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 1710I1003X Military Health Care Provider
Specialization: Independent Duty Medical Technicians
Other Service Providers

Office Location

Street Address 2422 ARCTIC AVE
APT D
City EIELSON AFB
State AK
Zip Code 99702

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1174864904 Eric Noll Optometrist 2630 Central Ave # 3349, Eielson Afb, AK 99702 2013-03-04
1407125123 Optical Center Technician/Technologist 451 Broadway Street, Eielson Afb Aafes Exchange, Eielson, AK 99702 2011-12-27
1063649234 John Michael Strothenke Military Health Care Provider 2630 Central Avenue Suite 1, 354 Medical Operations Squadron, Clinical Medicine Flt, Eielson Air Force Base, AK 99702 2009-06-16
1780875617 Victoria L Ketchum Specialist E. Cowles, Fairbanks Memorial Hospital, Fairbanks, AK 99702 2007-08-06
1689768103 Angie M. Walker Social Worker 2630 Central Av, Suite 1m07, Eielson Afb, AK 99702 2006-10-02
1306945464 354th Medical Group Mdg Military/U.S. Coast Guard Pharmacy Bldg 3349 Central Ave, Eielson Afb, AK 99702 2006-09-22
1760442297 Susan Mary Runyan Dietitian, Registered 354th Medical Group, 2630 Central Ave, Suite 1m07, Eielson Afb, AK 99702 2006-03-27
1972166916 Andrew Joseph Colburn Registered Nurse 2630 Central Ave # 3349, Eielson Afb, AK 99702 2019-04-16
1952885121 Anthony Ewell-kollmann Dentist 2630 Central Ave, Eielson Afb, AK 99702 2018-09-24
1306375704 Robert Marshall Walter Dentist 2630 Central Ave Bldg 3349, Eielson Afb, AK 99702 2017-06-08
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Taxonomy Information

Taxonomy Code 1710I1003X
Grouping Other Service Providers
Classification Military Health Care Provider
Specialization Independent Duty Medical Technicians

Taxonomy Definition

An Independent Duty Medical Technician (IDMT) is specially trained and educated to perform primary medical care, minor surgical services, and treatment of dental disorders for active duty military members in a variety of health care and non-health care settings worldwide under direct and indirect physician supervision. An IDMT may take medical histories, perform physical exams, order lab tests and x-rays, prescribe medications, and give immunizations. IDMTs work under the direct supervision of a physician preceptor when at home station and indirectly when assigned to a Mobile Aid Station, Mobile Medical Unit, remote site, or otherwise deployed specifically as an IDMT. An IDMT may be an experienced Aerospace Medical Service Technician who meets special task qualifications and is recommended for training by the Aerospace Medical Service Functional Manager at their Medical Treatment Facility. IDMTs maintain certification as Nationally Registered Emergency Medical Technicians and as Immunization Back-up Technicians.
Notes: Source: Air Force Surgeon General Office [7/1/2005: new]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1578189387 Eric Dylan Mason Military Health Care Provider 2630 Central Ave, Eielson Afb, AK 99702-2301 2020-06-18
1518586122 Amanda Nichols Military Health Care Provider 2630 Central Ave # 3349, Eielson Afb, AK 99702-2301 2020-04-14
1104393446 Matthew Gray Military Health Care Provider 2630 Central Ave, Eielson Afb, AK 99702-2301 2018-10-24
1730541038 Matthew Robert Kramer Military Health Care Provider 2630 Central Ave # 3349, Eielson Afb, AK 99702-2301 2016-03-25
1821225913 Alton E Doe Jr. Military Health Care Provider 2630 Central Ave, Ste 1, Eielson Afb, AK 99702-2301 2009-06-16
1982830287 Julianne Marie Lujan Military Health Care Provider 2630 Central Ave, 354 Mdos Flight Medicine Clinic, Eielson Afb, AK 99702-2301 2009-06-02
1851534184 Angelia Deanne Calder Military Health Care Provider 2630 Central Ave, Eielson Afb, AK 99702-2301 2009-04-16

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1861093304 Ryan Garcia Military Health Care Provider 673d Med Group, Jber, AK 99501 2020-11-02
1447850268 Ryan Rene Reyes Military Health Care Provider 1024 Nordale Rd, North Pole, AK 99705-5154 2020-10-30
1285055129 Jennifer Trout Military Health Care Provider 18226 Pioneer Dr, Eagle River, AK 99577-9331 2013-12-19
1063649234 John Michael Strothenke Military Health Care Provider 2630 Central Avenue Suite 1, 354 Medical Operations Squadron, Clinical Medicine Flt, Eielson Air Force Base, AK 99702 2009-06-16
1851853048 Jordan Matthew Cate Military Health Care Provider 5955 Zeamer Ave, Jber, AK 99506-3702 2019-04-05
1457810657 Mycala B Stedingh Military Health Care Provider 673 Mdg, 5955 Zeamer Ave, Jber, AK 99506 2019-03-18
1912481656 Colin Michael Mullaly Military Health Care Provider 5955 Zeamer Ave, Anchorage, AK 99506-3702 2018-09-19
1104303320 Luis Baltazar Baptista Military Health Care Provider 5955 Zeamer Ave, Jber, AK 99506-3702 2018-07-20
1780172122 Kathryn Noel Nyunt Military Health Care Provider 5955 Zeamer Ave, Anchorage, AK 99506-3702 2018-05-01
1922498096 Kari Lynn Robinson Military Health Care Provider 5955 Zeamer Ave, Jber, AK 99506-3702 2015-01-28
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Competitor

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City EIELSON AFB
Zip Code 99702

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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