TRIPLER ARMY MEDICAL CENTER (NPI# 1629482062) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1629482062 |
Entity Type | Organization |
Organization Name | TRIPLER ARMY MEDICAL CENTER |
Other Organization Name | DOD HICKAM EPHCY |
Practice Address |
755 Scott Cir Hickam Afb HI 96853-5399 |
Mailing Address |
Tripler Army Medical Center Pad Mchk-pat-t 1 Jarrett White Rd Honolulu HI 96859-5001 |
Practice Telephone | 8084486261 |
Practice Fax Number | 8084486740 |
Mailing Telephone | 8084486261 |
Mailing Fax Number | 8084486740 |
Enumeration Date | 2014-06-13 |
Last Update Date | 2016-04-05 |
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 | 2146307 | 01 |
Other Name | Type Code |
---|---|
DoD HICKAM ePhcy | Doing Business As Name - Organization |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1114230109 | Tripler Army Medical Center | Clinic/Center | 91-1010 Shangrila St, Suite 100, Kapolei, HI 96707-2161 | 2010-07-19 |
1538365036 | Tripler Army Medical Center | Clinic/Center | Bldg 660 Mccornack Road, Dental Clinic, Schofield Barracks, HI 96857 | 2007-06-22 |
1750599403 | Tripler Army Medical Center | Clinic/Center | Mccornack Rd Bldg 677, Schofield Barracks, HI 96857 | 2007-05-18 |
1841408598 | Tripler Army Medical Center | Clinic/Center | Mccornack Rd Bldg 682, Schofield Barracks, HI 96857 | 2007-05-18 |
1558460238 | Tripler Army Medical Center | Military/U.S. Coast Guard Pharmacy | Bldg 676, Schofield Barracks, HI 96857-5460 | 2006-09-21 |
1427157056 | Tripler Army Medical Center | Military/U.S. Coast Guard Pharmacy | Sand Island Access Rd Area 4, Honolulu, HI 96819 | 2006-09-21 |
1245628056 | Tripler Army Medical Center | Military/U.S. Coast Guard Pharmacy | 91-1010 Shangrila St Ste 100, Kapolei, HI 96707-2176 | 2014-12-31 |
1972919348 | Tripler Army Medical Center | Military/U.S. Coast Guard Pharmacy | Bldg 676, Schofield Barracks, HI 96857-5460 | 2014-07-07 |
1902218423 | Tripler Army Medical Center | Military/U.S. Coast Guard Pharmacy | 1 Jarrett White Rd, Tripler Army Medical Center, Tripler Amc, HI 96859-5001 | 2014-06-02 |
1588944821 | Tripler Army Medical Center | Military/U.S. Coast Guard Pharmacy | 91-1010 Shangrila St Ste 100, Kapolei, HI 96707-2176 | 2011-08-18 |
Entity Type | Entity Name | Entity Address |
---|---|---|
System for Award Management (SAM) Entities | TRIPLER ARMY MEDICAL CENTER | 1 Jarrett White Rd, Tripler Army Medical Center, HI 96859-5001 |
Street Address |
755 SCOTT CIR |
City | HICKAM AFB |
State | HI |
Zip Code | 96853-5399 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1548241276 | John Cinco | Family Medicine | 755 Scott Cir, Sgh, Hickam Afb, HI 96853-5399 | 2005-11-09 |
1225415235 | Sonia Evoy | Registered Nurse | 755 Scott Cir, 15th Medical Group, Hickam Afb, HI 96853-5399 | 2015-04-28 |
1922492537 | Tina Hairston | Dental Hygienist | 755 Scott Cir, Hickam Afb, HI 96853-5399 | 2015-03-20 |
1740626126 | Tyler Garrett | Dentist | 755 Scott Cir, Hickam Afb, HI 96853-5399 | 2013-05-13 |
1639300312 | Cameron Modisette | Military Health Care Provider | 755 Scott Cir, Hickam Afb, HI 96853-5399 | 2009-07-29 |
1669623690 | Kenneth Raymond Bellisle | Pharmacist | 755 Scott Cir, 15th Medical Group, Hickam Afb, HI 96853-5399 | 2008-10-08 |
1952582009 | Hickam Afb 15th Mdg | Clinic/Center | 755 Scott Cir, 15th Med Group, Hickam Afb, HI 96853-5399 | 2007-11-16 |
1063692234 | Anthony Mark Hall | Counselor | 755 Scott Cir, Bldg 559, Hickam Afb, HI 96853-5399 | 2007-11-05 |
1073656856 | Woody Charles Baker | Dentist | 755 Scott Cir, 15 Mdg Sgd, Hickam Afb, HI 96853-5399 | 2007-02-14 |
1649379322 | Hickam Phcy | Military/U.S. Coast Guard Pharmacy | 755 Scott Cir, Hickam Afb, HI 96853-5399 | 2006-09-21 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1467884759 | Edward Joseph Tucholski Jr. | Dentist | 15 Mdg, 755 Scott Circle, Jbphh, HI 96853 | 2013-08-08 |
1922232230 | Angela Marie Alveo-forbes | Military Health Care Provider | 375 Mamiya St, Bldg 2140, Hickam Ab, HI 96853 | 2009-05-14 |
1205180783 | John-michael Fowler | Registered Nurse | 755 Scott Circle, Jbphh, HI 96853 | 2012-11-05 |
1811250442 | April A Bronowski | Physical Therapist | 755 Scott Circle, 15 Mdg, Joint Base Pearl Harbor Hickam, HI 96853 | 2012-06-19 |
1609812163 | Joyce Ann Raszewski | Nurse Practitioner | 755 Scott Circle, Jbphh/hickam, HI 96853 | 2006-06-22 |
1720068976 | Richard Dale Quintana | Family Medicine | 15th Medical Group, Hickam Afb, Honolulu, HI 96853 | 2006-01-21 |
1124262746 | John Craig Bright | Military Health Care Provider | 15mdos/sgomf 755 Scott Circle, Hickam Afb, HI 96853-3672 | 2009-04-27 |
1134759715 | David Maldonado Santiago | Military Health Care Provider | 590 Moffet St, Jbphh, HI 96853-5168 | 2020-01-22 |
1366427395 | Lisa Katherine Rivera | Pathology | 590 Moffet St, Bldg 4077, Joint Base Pearl Harbor-hickam, Honolulu, HI 96853-5168 | 2005-12-13 |
1619154572 | Hickam Fire Emergency Services | Case Management | 345 Mamiya Avenue, Hickam, HI 96853-5233 | 2008-01-23 |
Find all providers in zip 96853 |
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 |
---|---|---|---|---|
1649379322 | Hickam Phcy | Military/U.S. Coast Guard Pharmacy | 755 Scott Cir, Hickam Afb, HI 96853-5399 | 2006-09-21 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1588079206 | Naval Health Clinic Hawaii | Military/U.S. Coast Guard Pharmacy | Makalapa Rd, Bldg 1407, Pearl Harbor, HI 96860 | 2014-06-23 |
1134397037 | Naval Health Clinic Hawaii | Military/U.S. Coast Guard Pharmacy | Camp Smith Medical Naval Annex, Camp Smith, HI 96861 | 2008-02-13 |
1902084577 | Naval Health Clinic Hawaii | Military/U.S. Coast Guard Pharmacy | Wahaiwa Brmax Eastpac, 500 Center St Bldg 22, Wahiawa, HI 96786 | 2008-02-06 |
1558460238 | Tripler Army Medical Center | Military/U.S. Coast Guard Pharmacy | Bldg 676, Schofield Barracks, HI 96857-5460 | 2006-09-21 |
1083713606 | Naval Health Clinic Hawaii | Military/U.S. Coast Guard Pharmacy | Bldg 1407, Pearl Harbor, HI 96860-4908 | 2006-09-21 |
1891894416 | Naval Health Clinic Hawaii | Military/U.S. Coast Guard Pharmacy | D Street Bldg 3089, Kaneohe, HI 96863-3066 | 2006-09-21 |
1427157056 | Tripler Army Medical Center | Military/U.S. Coast Guard Pharmacy | Sand Island Access Rd Area 4, Honolulu, HI 96819 | 2006-09-21 |
1588638167 | Us Air Force 15 Cpts Fmf PC | Military/U.S. Coast Guard Pharmacy | 15th Medical Group Sgsbr, 755 Scott Circle, Honolulu, HI 96853-5399 | 2006-02-13 |
1245628056 | Tripler Army Medical Center | Military/U.S. Coast Guard Pharmacy | 91-1010 Shangrila St Ste 100, Kapolei, HI 96707-2176 | 2014-12-31 |
1972919348 | Tripler Army Medical Center | Military/U.S. Coast Guard Pharmacy | Bldg 676, Schofield Barracks, HI 96857-5460 | 2014-07-07 |
Find all providers with the same taxonomy |
City | HICKAM AFB |
Zip Code | 96853 |
Please comment or provide details below to improve the information on TRIPLER ARMY MEDICAL CENTER.
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.