KIMBROUGH ACC MILITARY MTF (NPI# 1437563871) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1437563871 |
| Entity Type | Organization |
| Organization Name | KIMBROUGH ACC MILITARY MTF |
| Other Organization Name | DOD FT MEADE EPHCY |
| Practice Address |
2480 Llewellyn Ave Ste 5800 Kimbrough Ambulatory Care Center Fort Meade MD 20755-5129 |
| Mailing Address |
Kimbrough Acc Military Mtf Co Cdr Usameddac Mcxr-bd 2480 Luwellyn Ave Ste 5800 Ft Meade MD 20755-5129 |
| Practice Telephone | 3016778800 |
| Practice Fax Number | 3016778456 |
| Mailing Telephone | 3016778800 |
| Mailing Fax Number | 3016778456 |
| 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 |
|---|---|---|---|---|---|
| N | 333600000X | Pharmacy | Suppliers | ||
| Y | 332000000X | Military/U.S. Coast Guard Pharmacy | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PK | 2146217 | 01 |
| Other Name | Type Code |
|---|---|
| DoD FT MEADE ePhcy | 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 |
2480 LLEWELLYN AVE STE 5800 KIMBROUGH AMBULATORY CARE CENTER |
| City | FORT MEADE |
| State | MD |
| Zip Code | 20755-5129 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760464846 | Pascale Guirand | Nurse Practitioner | 2480 Llewellyn Ave Ste 5800, Fort Meade, MD 20755-5129 | 2005-11-15 |
| 1023326337 | Susan Daniela Gumpel | Family Medicine | 2480 Llewellyn Ave Ste 5800, Fort Meade, MD 20755-5129 | 2010-09-21 |
| 1194884098 | David Allen Zeller Jr. | Physician Assistant | 2480 Llewellyn Ave Ste 5800, Fort Meade, MD 20755-5129 | 2006-12-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215451216 | Patrick Hoye | Dentist | 8472 Simonds Street, Epes Dental Clinic, Ft. Meade, MD 20755 | 2017-08-01 |
| 1982150561 | Martha Davis | Technician | 2553 Hartel St, Fort Meade, MD 20755 | 2016-09-01 |
| 1649725995 | Jaclyn Leith | Psychologist | 2479 5th St., Ft. Meade, MD 20755 | 2016-08-16 |
| 1548613417 | Catherine Geller | Dental Hygienist | 8476 Simonds St, Suite 5700, Fort George G. Meade, MD 20755 | 2016-07-15 |
| 1396194510 | Cristina Ribeiro | Dental Hygienist | 8476 Simond St, Suite 5700, Fort George G. Meade, MD 20755 | 2016-06-08 |
| 1508215765 | Nicole Ferris | Dental Hygienist | 8476 Simond St Ste 5700, Fort George G. Meade, MD 20755 | 2016-06-08 |
| 1487031548 | Usv Optical Inc. | Eyewear Supplier (Equipment, not the service) | Rose Street, Bldg 2799, Ft Meade, MD 20755 | 2015-04-28 |
| 1801206685 | Kimbrough Acc Military Mtf | Pharmacy | 2799 Rose Street, Ft Meade, MD 20755 | 2014-05-02 |
| 1578980744 | Claudia Goleburn | Psychologist | 2479 5th St, Ft Meade, MD 20755 | 2014-03-25 |
| 1093063158 | Michael Elsworth Yapp | Pharmacist | 24180 Llewellyn Avenue, Fort Meade, MD 20755 | 2012-08-21 |
| Find all providers in zip 20755 | ||||
| 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 |
|---|---|---|---|---|
| 1548868870 | Walter Reed National Military Medical Center | Military/U.S. Coast Guard Pharmacy | 101 Buchanan Rd, Annapolis, MD 21402-5107 | 2020-10-09 |
| 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 |
| 1063763241 | National Naval Medical Center | Military/U.S. Coast Guard Pharmacy | 8901 Wisconsin Ave Dept Ofphcy, Bldg 9, Room 2303, Bethesda, MD 20889-0001 | 2012-09-27 |
| 1902905318 | Naval Health Clinic Patuxent River | Military/U.S. Coast Guard Pharmacy | Bldg 1370, Patuxent River, MD 20670 | 2006-09-22 |
| 1679672083 | Dunham Army Health Clinic | Military/U.S. Coast Guard Pharmacy | 1452 Porter St, Ft Detrick, MD 21702 | 2006-09-22 |
| 1851490270 | Malcom Grow Medical Center 79 Mdg Mdss Sgsr | Military/U.S. Coast Guard Pharmacy | 1050 W Perimeter Rd # D1119, Jb Andrews, MD 20762-6601 | 2006-09-22 |
| 1174620926 | Naval Health Clinic Patuxent River | Military/U.S. Coast Guard Pharmacy | Bldg 1600 Wilson Drive, Indian Head, MD 20640 | 2006-09-20 |
| 1265539019 | Malcom Grow Medical Center 79 Mdg Mdss Sgsr | Military/U.S. Coast Guard Pharmacy | 1 San Diego Loop Bldg 3188, Jb Andrews, MD 20762-5518 | 2006-09-20 |
| 1205242310 | Kimbrough Acc Military Mtf | Military/U.S. Coast Guard Pharmacy | 1434 Porter St, Frederick, MD 21702-9254 | 2014-07-09 |
| 1649682162 | Naval Health Clinic Annapolis | Military/U.S. Coast Guard Pharmacy | 695 Kinkaid Rd, Naval Health Clinic Annapolis, Annapolis, MD 21402 | 2014-06-02 |
| Find all providers with the same taxonomy | ||||
| City | FORT MEADE |
| Zip Code | 20755 |
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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.