BENJAMIN ANDREW GALLENTINE (NPI# 1578103461) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1578103461 |
Entity Type | Individual |
Full Name | BENJAMIN ANDREW GALLENTINE |
Practice Address |
7219 N Litchfield Rd Glendale AZ 85309-1529 |
Practice Telephone | 6238562273 |
Mailing Telephone | 6238562273 |
Enumeration Date | 2020-01-09 |
Last Update Date | 2020-01-09 |
Gender Code | M |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 1710I1003X |
Military Health Care Provider Specialization: Independent Duty Medical Technicians |
Other Service Providers |
Street Address |
7219 N LITCHFIELD RD |
City | GLENDALE |
State | AZ |
Zip Code | 85309-1529 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1346888088 | Justin Banghart | Physician Assistant | 7219 N Litchfield Rd, Glendale, AZ 85309-1529 | 2019-12-12 |
1225695935 | Hannah Toberman | Physician Assistant | 7219 N Litchfield Rd, Glendale, AZ 85309-1529 | 2019-05-29 |
1487027538 | Lucas Kim | Dentist | 7219 N Litchfield Rd, Glendale, AZ 85309-1529 | 2015-11-10 |
1316315666 | Brooke Ryan | Physician Assistant | 7219 N Litchfield Rd, Glendale, AZ 85309-1529 | 2015-09-03 |
1205231727 | Jovens Colas | Social Worker | 7219 N Litchfield Rd, Glendale, AZ 85309-1529 | 2014-10-27 |
1659770840 | Michael J Saxton | Dentist | 7219 N Litchfield Rd, Glendale, AZ 85309-1529 | 2014-08-14 |
1316245764 | Anthony Bradford Wilson | Military Health Care Provider | 7219 N Litchfield Rd, Glendale, AZ 85309-1529 | 2011-03-09 |
1528374154 | Amanda Octavia Nichole Hardy | Psychologist | 7219 N Litchfield Rd, Glendale, AZ 85309-1529 | 2010-08-20 |
1578716965 | Julie Ann Gerhart | Pharmacist | 7219 N Litchfield Rd, Glendale, AZ 85309-1529 | 2008-10-29 |
1902967490 | Gerald Bernard Goldstein | Dentist | 7219 N Litchfield Rd, ., Glendale, AZ 85309-1529 | 2006-12-12 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1912466111 | Natalie Ann Korona | Nurse Practitioner | 56 Mdg/mdos/sgof, 7219 N. Litchfield Rd, Luke Afb, AZ 85309 | 2019-03-18 |
1558647024 | Cheng Chung Tsai | Pharmacist | 72 19 N Litchfield Road, 56 Medical Group, Luke Afb, AZ 85309 | 2011-10-28 |
1053617464 | Bradley William Snyder | Military Health Care Provider | 7224 North 139th Avenue, Glendale, AZ 85309 | 2011-02-02 |
1043516610 | Charles Delvon Pickett | Military Health Care Provider | 7019 N Litchfield Ave, Luke Afb, 56/amds, Luke Afb, AZ 85309 | 2011-01-31 |
1104980663 | Maurice Edgar Young | Obstetrics & Gynecology | 56th Aerospace Medicine Squadron, Luke Afb, AZ 85309 | 2006-12-20 |
1679658538 | Wayne Allen Beaver | Psychologist | Luke Air Force Base, Bldg 317, Glendale, AZ 85309 | 2006-10-26 |
1306945472 | 56th Medical Group Sgsl | Military/U.S. Coast Guard Pharmacy | Bldg 810, Luke Afb, AZ 85309 | 2006-09-22 |
1679676571 | Anita Glenn-reller | Counselor | 317 Lightning Ave, Luke Afb, AZ 85309 | 2006-09-06 |
1346784881 | Kaleigh Moses | Registered Nurse | 13960 W Eagle St, Luke Air Force Base, AZ 85309-1426 | 2016-12-16 |
1376893511 | Melissa Ann Parra | Dentist | 7219 N Litchfield Rd., 56th Medical Group, Luke Afb, AZ 85309-1525 | 2012-09-14 |
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Taxonomy Code | 1710I1003X |
Grouping | Other Service Providers |
Classification | Military Health Care Provider |
Specialization | Independent Duty Medical Technicians |
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] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1053617464 | Bradley William Snyder | Military Health Care Provider | 7224 North 139th Avenue, Glendale, AZ 85309 | 2011-02-02 |
1376779959 | Tracey L Gilmore | Military Health Care Provider | 3739 W Helena Dr, Glendale, AZ 85308-3105 | 2009-06-09 |
1316245764 | Anthony Bradford Wilson | Military Health Care Provider | 7219 N Litchfield Rd, Glendale, AZ 85309-1529 | 2011-03-09 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1225657828 | Casey Mulcahy | Military Health Care Provider | 2748 N 60th St, Scottsdale, AZ 85257-1012 | 2020-04-13 |
1194375667 | Nathan Andrew Lawson | Military Health Care Provider | 2336 E Libra Pl, Chandler, AZ 85249-3790 | 2019-09-17 |
1043787450 | Dustin Alford | Military Health Care Provider | 4280 E Burnsey Ln, Kingman, AZ 86401-5595 | 2018-10-24 |
1306259171 | Aaron Alvarez | Military Health Care Provider | 18026 W Carol Ave, Waddell, AZ 85355-4127 | 2014-06-09 |
1891118774 | Vianca Mendoza | Military Health Care Provider | 17714 W Desert Ln, Surprise, AZ 85388-1714 | 2014-01-28 |
1831449180 | Ronald John Borgstrom II | Military Health Care Provider | 15053 W Mulberry Dr, Goodyear, AZ 85395-8846 | 2012-09-13 |
1821358102 | Ngu Quang Do | Military Health Care Provider | 407 Campbell St, Prescott, AZ 86301-2518 | 2012-05-21 |
1043516610 | Charles Delvon Pickett | Military Health Care Provider | 7019 N Litchfield Ave, Luke Afb, 56/amds, Luke Afb, AZ 85309 | 2011-01-31 |
1235433756 | Esmat Marie Sabbagh | Military Health Care Provider | 5020 E Arizola St, Davis Monthan Afb, AZ 85707-3108 | 2010-12-23 |
1417267949 | Humberto Alcocer | Military Health Care Provider | 4159 W 3rd Pl, Yuma, AZ 85364-1009 | 2010-10-18 |
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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.