KENNER ARMY HEALTH CLINIC (NPI# 1417361866) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417361866 |
| Entity Type | Organization |
| Organization Name | KENNER ARMY HEALTH CLINIC |
| Other Organization Name | DOD FT LEE EPHCY |
| Practice Address |
700 24th St Bldg 8130 Kenner Army Health Clinic Fort Lee VA 23801-1716 |
| Mailing Address |
Kenner Army Health Clinic Co Pad 700 24th St Fort Lee VA 23801-1716 |
| Practice Telephone | 8047349137 |
| Practice Fax Number | 8047349658 |
| Mailing Telephone | 8047349137 |
| Mailing Fax Number | 8047349658 |
| Enumeration Date | 2014-06-13 |
| Last Update Date | 2017-02-16 |
| Authorized Official Name | HECTOR MORALES (CHIEF DHA PASS) |
| Authorized Official Telephone | 2105366650 |
| 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 | 2146215 | 01 |
| Other Name | Type Code |
|---|---|
| DoD FT LEE ePhcy | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215218342 | Kenner Army Health Clinic | Clinic/Center | 8204 Ave C, Fort Lee, VA 23801-1716 | 2011-09-02 |
| 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 |
| 1043591175 | Kenner Army Health Clinic | Clinic/Center | 700 24th St, Bldg 3219 Ncxo Tmc, Fort Lee, VA 23801-1716 | 2011-09-02 |
| 1497036529 | Kenner Army Health Clinic | Clinic/Center | 2601 C Ave, Tmc 2 Bld T8204, Fort Lee, VA 23801-1717 | 2011-09-02 |
| 1811285034 | Kenner Army Health Clinic | Military/U.S. Coast Guard Pharmacy | 700 24th St, Kenner Army Health Clinic, Fort Lee, VA 23801-1716 | 2011-07-21 |
| 1689879330 | Kenner Army Health Clinic | Clinic/Center | 2601 C Ave, Fort Lee, VA 23801-1717 | 2007-06-20 |
| 1164640504 | Kenner Army Health Clinic | Clinic/Center | 700 24th St, Fort Lee, VA 23801-1716 | 2007-04-23 |
| 1891854014 | Kenner Army Health Clinic | Clinic/Center | 700 24th St, Fort Lee, VA 23801-1716 | 2006-12-06 |
| 1356330641 | Kenner Army Health Clinic | Clinic/Center | 700 24th St, Fort Lee, VA 23801-1716 | 2005-10-19 |
| Street Address |
700 24TH ST BLDG 8130 KENNER ARMY HEALTH CLINIC |
| City | FORT LEE |
| State | VA |
| Zip Code | 23801-1716 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306814827 | Estela Torres Smith | Radiology | 700 24th St Bldg 8130, Fort Lee, VA 23801-1716 | 2006-03-10 |
| 1487032256 | Lisabeth P Grove | Registered Nurse | 700 24th St Bldg 8130, Fort Lee, VA 23801-1716 | 2015-05-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790262384 | Usv Optical Inc. | Eyewear Supplier (Equipment, not the service) | Ft. Lee 300 A Ave., Fort Lee, VA 23801 | 2018-07-26 |
| 1770812190 | Arkeye | Optometrist | 300 A Avenue, Bldg 1605, Fort Lee, VA 23801 | 2009-12-14 |
| 1992911044 | Claudis Andre' Williams Jr. | Physician Assistant | 700 24th St., Kenner Army Health Clinic, Ft. Lee, VA 23801 | 2007-05-15 |
| 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 |
| 1538135157 | Laurie Sue Giertz | Physician Assistant | 700 24th St Apt Hill, Fort Lee, VA 23801 | 2006-02-24 |
| 1689653396 | Robert Keith Lather | Emergency Medicine | Kenner Army Health Clinic, Primary Care Division, Ft Lee, VA 23801 | 2006-01-11 |
| 1265418370 | Edward Cathright Jr. | Dentist | 504 Trenton Drive, Fort Lee, VA 23801 | 2005-12-20 |
| 1801854807 | Mack Conley O'quinn Jr. | Social Worker | 700 24th Street, Kenner Army Health Clinic, Fort Lee, VA 23801 | 2006-05-02 |
| 1083690028 | Kimberly Ellen Newton | Registered Nurse | 700 24th Street, Usameddac Kahc Attn: Credentials Office, Fort Lee, VA 23801 | 2005-12-21 |
| Find all providers in zip 23801 | ||||
| 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 |
|---|---|---|---|---|
| 1811285034 | Kenner Army Health Clinic | Military/U.S. Coast Guard Pharmacy | 700 24th St, Kenner Army Health Clinic, Fort Lee, VA 23801-1716 | 2011-07-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174172183 | Naval Health Clinic Annapolis | Military/U.S. Coast Guard Pharmacy | 17457 Caffee Rd Bldg 192, Dahlgren, VA 22448-5120 | 2019-09-11 |
| 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 |
| Find all providers with the same taxonomy | ||||
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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.