121ST CSH/BAACH (NPI# 1700082880) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700082880 |
| Entity Type | Organization |
| Organization Name | 121ST CSH/BAACH |
| Other Organization Name | USADC KR SEOUL |
| Practice Address |
Unit 15652, Bldg 5107 Apo AP 96205 |
| Mailing Address |
Box 316 Unit 15244 Apo AP 96205 |
| Practice Telephone | 01182279171410 |
| Mailing Telephone | 01182279171858 |
| Enumeration Date | 2007-06-25 |
| Last Update Date | 2014-01-03 |
| Authorized Official Name | CHONG MCCUE (CHIEF, UBO) |
| Authorized Official Telephone | 01182279171857 |
| Is Organization Subpart | Y |
| Parent Organization Name | 121ST CSH/BAACH |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM1100X |
Clinic/Center Specialization: Military/U.S. Coast Guard Outpatient |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| USADC KR SEOUL | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568660348 | 121st Csh/baach | Clinic/Center | Unit 15652, Bldg 1665, Apo, AP 96205 | 2007-07-03 |
| 1811195696 | 121st Csh/baach | Clinic/Center | Unit 15652, Bldg 3576, Apo, AP 96205 | 2007-07-03 |
| 1457559239 | 121st Csh/baach | Clinic/Center | Unit 15652, Bldg 7005, Apo, AP 96205 | 2007-07-03 |
| 1730387515 | 121st Csh/baach | Clinic/Center | Unit 15652, Bldg S4034, Apo, AP 96205 | 2007-07-03 |
| 1306042494 | 121st Csh/baach | Clinic/Center | Unit 15658, Bldg 808, Apo, AP 96224 | 2007-06-25 |
| 1730385824 | 121st Csh/baach | Clinic/Center | Unit 15659, Bldg 220, Apo, AP 96218 | 2007-06-25 |
| 1215133301 | 121st Csh/baach | Clinic/Center | Unit 15660, Bldg 555, Apo, AP 96271 | 2007-06-25 |
| 1053517144 | 121st Csh/baach | Clinic/Center | Unit 15663, Bldg 600, Apo, AP 96297 | 2007-06-25 |
| 1295931384 | 121st Csh/baach | Clinic/Center | Unit 15653, Bldg S306, Apo, AP 96258 | 2007-06-25 |
| 1063618148 | 121st Csh/baach | Clinic/Center | Unit 15662, Bldg S137, Apo, AP 96260 | 2007-06-25 |
| Street Address |
UNIT 15652, BLDG 5107 |
| City | APO |
| State | AP |
| Zip Code | 96205 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518450394 | Charles D Walker | Nurse Practitioner | 0121 Md Hsp Combat Support, Apo, AP 96205 | 2018-06-07 |
| 1952815235 | Robert Martinusek | Physical Therapist | Brian Allgood Army Community Hospital Unit 15543, Bldg 7005, Apo, AP 96205 | 2017-11-26 |
| 1659897056 | Laura Tsu | Dentist | 618 Mc Co Dental Com Wbpdaa, Yong San, AP 96205 | 2017-08-17 |
| 1962959502 | Amy Lee Wooten | Nurse Anesthetist, Certified Registered | Brian Allgood Army Hospital, Unit 15244, Camp Humphreys, KOREA 96205 | 2016-09-01 |
| 1912451105 | Laurel Alison Kessler | Dentist | 618 Md Co Dental Company, Apo, AP 96205 | 2016-08-05 |
| 1396116059 | Stephanie Louise Wheeler | Counselor | Hq, Usameddac-korea, Unit 15281, Apo, AP 96205 | 2015-10-07 |
| 1720454994 | Jared Colin Stewart | Dentist | 618th Dental Company, Usa Dentac Korea, Unit 15652, Apo, AP 96205 | 2015-08-11 |
| 1356717524 | John Carmen Warren | Dentist | 618th Dental Company, Usa Dentac - Korea, Unit # 15652, Apo, AP 96205 | 2015-08-11 |
| 1912381823 | Chanise Garvin-dumay | Registered Nurse | 121 Csh/baach. Pad, Yongsan, Apo, AP 96205 | 2015-07-10 |
| 1245611854 | Sabrina Emerald Kunciw | Family Medicine | 121 Csh/baach, Building #17005, Apo, AP 96205 | 2015-06-10 |
| Find all providers in zip 96205 | ||||
| Taxonomy Code | 261QM1100X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Military/U.S. Coast Guard Outpatient |
| The Defense Health Program or U.S. Coast Guard funded "fixed" facilities or distinct parts of a facility, providing outpatient medical and dental services, primarily for Uniformed Services beneficiaries. A "fixed" facility is a non-temporary, non-deployed facility. It includes mobile specialty units such as Magnetic Resonance Imaging (MRI) units that may furnish services at the "fixed" facility. It includes, as examples, the institutional portion of outpatient encounters (except Ambulatory Procedure Visits), supplies issued (e.g., glasses, ostomy supplies, crutches), and radiology and laboratory studies. Does not include items issued directly to a patient from an outpatient pharmacy or patient transport. |
| Notes: Source: TRICARE Management Activity Uniform Business Office User’s Guide [1/1/2005: title modified, definition added; 7/1/2006 title modified, definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891982518 | Jtf-b Med El-honduras | Clinic/Center | Unit 5700, Apo, AA 34042 | 2007-09-26 |
| 1568660348 | 121st Csh/baach | Clinic/Center | Unit 15652, Bldg 1665, Apo, AP 96205 | 2007-07-03 |
| 1811195696 | 121st Csh/baach | Clinic/Center | Unit 15652, Bldg 3576, Apo, AP 96205 | 2007-07-03 |
| 1457559239 | 121st Csh/baach | Clinic/Center | Unit 15652, Bldg 7005, Apo, AP 96205 | 2007-07-03 |
| 1730387515 | 121st Csh/baach | Clinic/Center | Unit 15652, Bldg S4034, Apo, AP 96205 | 2007-07-03 |
| 1306042494 | 121st Csh/baach | Clinic/Center | Unit 15658, Bldg 808, Apo, AP 96224 | 2007-06-25 |
| 1730385824 | 121st Csh/baach | Clinic/Center | Unit 15659, Bldg 220, Apo, AP 96218 | 2007-06-25 |
| 1215133301 | 121st Csh/baach | Clinic/Center | Unit 15660, Bldg 555, Apo, AP 96271 | 2007-06-25 |
| 1053517144 | 121st Csh/baach | Clinic/Center | Unit 15663, Bldg 600, Apo, AP 96297 | 2007-06-25 |
| 1295931384 | 121st Csh/baach | Clinic/Center | Unit 15653, Bldg S306, Apo, AP 96258 | 2007-06-25 |
| Find all providers in APO | ||||
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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.