MARTIN ARMY COMMUNITY HOSPITAL (NPI# 1649379314) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649379314 |
| Entity Type | Organization |
| Organization Name | MARTIN ARMY COMMUNITY HOSPITAL |
| Other Organization Name | BENNING MAIN OP PHCY |
| Practice Address |
Marne Rd Bldg 9200 Ft Benning GA 31905 |
| Mailing Address |
Martin Army Community Hospital C/o Mcxb-pp Meddac 6600 Van Aalst Blvd Bldg 9250 Ft Benning GA 31905-2102 |
| Practice Telephone | 7065441049 |
| Practice Fax Number | 7065441869 |
| Mailing Telephone | 7624082273 |
| Enumeration Date | 2006-09-21 |
| Last Update Date | 2020-10-06 |
| 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 | 2020268 | 01 |
| Other Name | Type Code |
|---|---|
| BENNING MAIN OP PHCY | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023378403 | Martin Army Community Hospital | Military/U.S. Coast Guard Pharmacy | 1100 Brookstone Centre Pkwy Rm 128, Columbus, GA 31904-4577 | 2012-05-21 |
| 1780942664 | Martin Army Community Hospital | Military Hospital | 8830 Watkins Ave, Fort Benning, GA 31905-5529 | 2012-04-27 |
| 1588945612 | Martin Army Community Hospital | Clinic/Center | 4327 North El Salvador Way, Eglin Afb, FL 32542 | 2011-09-02 |
| 1992009401 | Martin Army Community Hospital | Military/U.S. Coast Guard Pharmacy | 6998 Old Cusseta Rd Bldg 4202, Fort Benning, GA 31905-5431 | 2010-12-28 |
| 1053624130 | Martin Army Community Hospital | Clinic/Center | 6976 Old Cusseta Rd, Harmony Church, Fort Benning, GA 31905-5431 | 2010-07-19 |
| 1902128077 | Martin Army Community Hospital | Clinic/Center | 7191 Kanopsky Ave, Bldg. #2625, Fort Benning, GA 31905-4540 | 2010-02-17 |
| 1063616266 | Martin Army Community Hospital | Clinic/Center | 9200 Mame Road, Fort Benning, GA 31905 | 2007-06-12 |
| 1245434448 | Martin Army Community Hospital | Clinic/Center | 2622 Soldiers Plaza, Fort Benning, GA 31905 | 2007-06-12 |
| 1083818280 | Martin Army Community Hospital | Clinic/Center | 2828 Sightseeing Road, Fort Benning, GA 31905 | 2007-06-12 |
| 1891999090 | Martin Army Community Hospital | Clinic/Center | 3255 Sand Hill, 11th Abn Div Rd, Fort Benning, GA 31905 | 2007-06-12 |
| Street Address |
MARNE RD BLDG 9200 |
| City | FT BENNING |
| State | GA |
| Zip Code | 31905 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134741366 | Micah Elizabeth Lajoie | Specialist/Technologist | 7148 2nd Cavalry Street, Ft. Benning, GA 31905 | 2020-05-11 |
| 1598301384 | Tiffany Nicole Wolfe | Physical Therapist | 7446 Sightseeing Road, Bldg 2515, Ft Benning, GA 31905 | 2019-11-27 |
| 1790261022 | Kyle Joseph Burkardt | Dentist | Love Dental Clinic, 7101 Hoff St, Bldg 9240, Apo, AA 31905 | 2018-07-19 |
| 1821514449 | Rebekah Schott | Dentist | 7101 Hoff St., Fort Benning, GA 31905 | 2017-08-15 |
| 1043757677 | Karen Tolliver | Dental Hygienist | 7770 Sightseeing Rd, Bldg 2828, Fort Benning, GA 31905 | 2017-01-20 |
| 1356897953 | Katelyn Dolezal | Student in an Organized Health Care Education/Training Program | 6600 Van Aalst Blvd, Bldg 9250, Fort Benning, GA 31905 | 2016-09-01 |
| 1043663636 | Vicky J. Nehl | Dental Hygienist | 11th Abn Div Rd, Bldg 3255, Fort Benning, GA 31905 | 2016-07-19 |
| 1376992719 | Xenia Key | Dental Assistant | 7770 Sightseeing Road, Bernheim Dental Clinic, Fort Benning, GA 31905 | 2016-06-07 |
| 1588013189 | Barbara Parker | Dental Assistant | 2828 Sightseeing Rd, Fort Benning, GA 31905 | 2016-06-06 |
| 1568811255 | Tavonna Ashley | Dental Hygienist | 7107 Hoff Street, Apo, AA 31905 | 2016-06-03 |
| Find all providers in zip 31905 | ||||
| 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 |
|---|---|---|---|---|
| 1548369150 | Martin Army Community Hospital | Military/U.S. Coast Guard Pharmacy | Marne Rd Bldg 9230, Ft Benning, GA 31905 | 2006-09-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023378403 | Martin Army Community Hospital | Military/U.S. Coast Guard Pharmacy | 1100 Brookstone Centre Pkwy Rm 128, Columbus, GA 31904-4577 | 2012-05-21 |
| 1477811149 | Winn - Third Party Insurance | Military/U.S. Coast Guard Pharmacy | Bldg 8435, 306 Vanguard Road, Ft Stewart, GA 31314 | 2012-05-01 |
| 1992009401 | Martin Army Community Hospital | Military/U.S. Coast Guard Pharmacy | 6998 Old Cusseta Rd Bldg 4202, Fort Benning, GA 31905-5431 | 2010-12-28 |
| 1427131432 | Eisenhower Army Medical Center | Military/U.S. Coast Guard Pharmacy | 29709 B Street, Fort Gordon, GA 30905-5741 | 2006-10-23 |
| 1790875029 | Winn-third Party Insurance | Military/U.S. Coast Guard Pharmacy | Hunter Af Bldg, Bldg 1450, Savannah, GA 31409 | 2006-10-16 |
| 1457450066 | Eisenhower Army Medical Center | Military/U.S. Coast Guard Pharmacy | Bldg 366, Ft Macpherson, GA 30330-5000 | 2006-09-21 |
| 1497854160 | Eisenhower Army Medical Center | Military/U.S. Coast Guard Pharmacy | East Hospital Rd, Bldg 300 Rm 2c22, Ft Gordon, GA 30905 | 2006-09-21 |
| 1215036983 | Eisenhower Army Medical Center | Military/U.S. Coast Guard Pharmacy | Avenue B Bldg 29709, Mark Connelly Health Clinic, Ft Gordon, GA 30905 | 2006-09-21 |
| 1467559211 | Winn-third Party Insurance | Military/U.S. Coast Guard Pharmacy | 1061 Harmon Ave Ste 2j11b, Fort Stewart, GA 31314-5641 | 2006-09-20 |
| 1376640128 | Kings Bay Pharmacy | Military/U.S. Coast Guard Pharmacy | 881 Uss James Madison Rd Bldg 1028, Navsubase, Kings Bay, GA 31547-2531 | 2006-09-20 |
| Find all providers with the same taxonomy | ||||
| City | FT BENNING |
| Zip Code | 31905 |
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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.