GENERAL LEONARD WOOD ARMY COMMUNITY HOSPITAL (NPI# 1609289362) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609289362 |
| Entity Type | Organization |
| Organization Name | GENERAL LEONARD WOOD ARMY COMMUNITY HOSPITAL |
| Other Organization Name | DOD FT LEONARD WOOD EPHCY |
| Practice Address |
126 Missouri Ave General Leonard Wood Army Community Hospital Fort Leonard Wood MO 65473-8952 |
| Mailing Address |
General Leonard Wood Army Community Hospital Co Mcxp Rmd Bb 126 Missouri Avenue Ft. Leonard Wood MO 65473-8952 |
| Practice Telephone | 5735961709 |
| Practice Fax Number | 5735960405 |
| Mailing Telephone | 5735961709 |
| Mailing Fax Number | 5735960405 |
| Enumeration Date | 2014-06-10 |
| Last Update Date | 2016-03-29 |
| 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 | 2146212 | 01 |
| Other Name | Type Code |
|---|---|
| DoD FT LEONARD WOOD ePhcy | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366812091 | General Leonard Wood Army Community Hospital | Clinic/Center | 7621 Big Piney Rd, Fort Leonard Wood, MO 65473-1572 | 2015-10-07 |
| 1548656044 | General Leonard Wood Army Community Hospital | Clinic/Center | 12720 Kansas Ave, Bldg 789, Fort Leonard Wood, MO 65473 | 2015-04-10 |
| 1568762110 | General Leonard Wood Army Community Hospital | Military Hospital | 126 Missouri Ave., Fort Leonard Wood, MO 65473 | 2010-10-29 |
| 1942529961 | General Leonard Wood Army Community Hospital | Clinic/Center | 194 Eastlawn Ave, Suite D, Saint Robert, MO 65584-3701 | 2010-06-01 |
| 1700081700 | General Leonard Wood Army Community Hospital | Clinic/Center | West 4th and Virginia Street, Fort Leonard Wood, MO 65473 | 2007-06-19 |
| 1114133923 | General Leonard Wood Army Community Hospital | Clinic/Center | 4300 Goodfellow Blvd, Goodfellow Complex Bldg 103d, Saint Louis, MO 63120-1703 | 2007-05-16 |
| 1033325840 | General Leonard Wood Army Community Hospital | Clinic/Center | Alabama Avenue Bldg 885, Fort Leonard Wood, MO 65473-8952 | 2007-05-16 |
| 1306945738 | General Leonard Wood Army Community Hospital | Military/U.S. Coast Guard Pharmacy | 4430 Missouri Ave Bldg 360, Fort Leonard Wood, MO 65473-9098 | 2006-09-22 |
| 1225083249 | General Leonard Wood Army Community Hospital | Clinic/Center | 4430 Missouri Ave, Fort Leonard Wood, MO 65473-9098 | 2006-05-24 |
| 1275920076 | General Leonard Wood Army Community Hospital | Military/U.S. Coast Guard Pharmacy | 4430 Missouri Ave, General Leonard Wood Ach, Fort Leonard Wood, MO 65473-9098 | 2015-04-20 |
| Street Address |
126 MISSOURI AVE GENERAL LEONARD WOOD ARMY COMMUNITY HOSPITAL |
| City | FORT LEONARD WOOD |
| State | MO |
| Zip Code | 65473-8952 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336138643 | Thomas Houston Hume II | Physician Assistant | 126 Missouri Ave, Glwach Attn Mcxp Ccs Cr, Fort Leonard Wood, MO 65473-8952 | 2005-10-19 |
| 1881052504 | Allan Anthony Bolido | Nurse Anesthetist, Certified Registered | 126 Missouri Ave, Fort Leonard Wood, MO 65473-8952 | 2016-02-09 |
| 1801260625 | Bridget Farris | Technician | 126 Missouri Ave, Fort Leonard Wood, MO 65473-8952 | 2015-11-17 |
| 1992181515 | Brian Michael Lowery | Nurse Anesthetist, Certified Registered | 126 Missouri Ave, Fort Leonard Wood, MO 65473-8952 | 2015-08-05 |
| 1922480722 | Nathaniel Louis Fielding | Physician Assistant | 126 Missouri Ave, Fort Leonard Wood, MO 65473-8952 | 2015-06-29 |
| 1033546148 | David F Boyd IIi | Nurse Practitioner | 126 Missouri Ave, General Leonard Wood Community Hospital, Fort Leonard Wood, MO 65473-8952 | 2013-10-03 |
| 1780022673 | Robert Eric Sapp Sr. | Pharmacist | 126 Missouri Ave, Fort Leonard Wood, MO 65473-8952 | 2013-06-12 |
| 1184061277 | Lachell Wardell | Pharmacist | 126 Missouri Ave, Stop (box #1240), Fort Leonard Wood, MO 65473-8952 | 2013-05-29 |
| 1114360351 | Gary Evans | Social Worker | 126 Missouri Ave, Fort Leonard Wood, MO 65473-8952 | 2013-04-08 |
| 1710230008 | Melissa Rose Jones | Registered Nurse | 126 Missouri Ave, Fort Leonard Wood, MO 65473-8952 | 2012-10-24 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770192759 | Clara Boo Chai | Physician Assistant | General Leonard Wood Army Community Hospital, 4430 Missouri Ave, #1267, Fort Leonard Wood, MO 65473 | 2020-07-27 |
| 1982198453 | Traci Anne Shambo | Dental Hygienist | Bldg. 400 Virginia Ave, Fort Leonard Wood, MO 65473 | 2018-06-19 |
| 1083133771 | Mary Joan Klemp | Family Medicine | Ganeral Leonard Wood Army Community Hospital, 4430 Missouri Ave; Meddac Case Management; Primary Care, Fort Leonard Wood, MO 65473 | 2017-09-13 |
| 1255791851 | Sarah Elizabeth Joy | Physician Assistant | 885 West 16th Street, Fort Leonard Wood, MO 65473 | 2016-02-25 |
| 1548626948 | Jaimie-lee Musen | Physical Therapist | 4430 Missouri Ave, Glwach, Fort Leonard Wood, MO 65473 | 2016-01-14 |
| 1609240852 | Angela Carson | Registered Nurse | 4330 Missouri Avenue, Fort Leonard Wood, MO 65473 | 2015-11-25 |
| 1811379407 | Katharine Leigh Stringer | Dentist | 12720 Kansas Avenue, Fort Leonard Wood, MO 65473 | 2015-06-19 |
| 1548656044 | General Leonard Wood Army Community Hospital | Clinic/Center | 12720 Kansas Ave, Bldg 789, Fort Leonard Wood, MO 65473 | 2015-04-10 |
| 1740670314 | Terricka Stewart | Specialist/Technologist | 885 West 16th St., Fort Leonard Wood, MO 65473 | 2015-02-03 |
| 1427467265 | Dianna Morrison | Social Worker | 4430 Missouri Ave Box 1278, Fort Leonard Wood, MO 65473 | 2014-08-06 |
| Find all providers in zip 65473 | ||||
| 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 |
|---|---|---|---|---|
| 1306945738 | General Leonard Wood Army Community Hospital | Military/U.S. Coast Guard Pharmacy | 4430 Missouri Ave Bldg 360, Fort Leonard Wood, MO 65473-9098 | 2006-09-22 |
| 1275920076 | General Leonard Wood Army Community Hospital | Military/U.S. Coast Guard Pharmacy | 4430 Missouri Ave, General Leonard Wood Ach, Fort Leonard Wood, MO 65473-9098 | 2015-04-20 |
| 1548657612 | General Leonard Wood Army Community Hospital | Military/U.S. Coast Guard Pharmacy | 4430 Missouri Ave, Glwach Pharmacy, Fort Leonard Wood, MO 65473-9098 | 2015-04-16 |
| 1841355153 | General Leonardwood Army Community Hospital | Military/U.S. Coast Guard Pharmacy | 4430 Missouri Ave, Fort Leonard Wood, MO 65473-9098 | 2006-12-27 |
| 1720141419 | General Leonard Wood Army Community Hospital | Military/U.S. Coast Guard Pharmacy | 4430 Missouri Ave, Bldg 885 W 16th St, Fort Leonard Wood, MO 65473-9098 | 2006-12-18 |
| 1689773012 | General Leonard Wood Army Community Hospital | Military/U.S. Coast Guard Pharmacy | 126 Missouri Ave, Bldg 885 W 16th St, Fort Leonard Wood, MO 65473-8952 | 2006-09-22 |
| 1386743714 | General Leonard Wood Army Community Hospital | Military/U.S. Coast Guard Pharmacy | 4430 Missouri Ave, Fort Leonard Wood, MO 65473-9098 | 2006-09-22 |
| 1427157858 | General Leonard Wood Army Comm Hosp | Military/U.S. Coast Guard Pharmacy | 4430 Missouri Ave, Fort Leonard Wood, MO 65473-9098 | 2006-09-22 |
| 1336248764 | General Leonard Wood Army Community Hospital | Military/U.S. Coast Guard Pharmacy | 4430 Missouri Ave, Fort Leonard Wood, MO 65473-9098 | 2006-09-22 |
| 1245339670 | General Leonardwood Army Comm Hosp | Military/U.S. Coast Guard Pharmacy | 4430 Missouri Ave, Fort Leonard Wood, MO 65473-9098 | 2006-09-22 |
| Find all providers in FORT LEONARD WOOD | ||||
| City | FORT LEONARD WOOD |
| Zip Code | 65473 |
Please comment or provide details below to improve the information on GENERAL LEONARD WOOD ARMY COMMUNITY HOSPITAL.
| 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.