BAYNE-JONES ARMY COMMUNITY HOSPITAL (NPI# 1710224514) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710224514 |
| Entity Type | Organization |
| Organization Name | BAYNE-JONES ARMY COMMUNITY HOSPITAL |
| Other Organization Name | POLK TMC 1 PHCY |
| Practice Address |
8091 Georgia Ave Bldg 3504 Fort Polk LA 71459-5468 |
| Mailing Address |
1585 3rd St Bldg 285 Fort Polk LA 71459-5102 |
| Practice Telephone | 3375316131 |
| Practice Fax Number | 3375318728 |
| Mailing Telephone | 3375313482 |
| Enumeration Date | 2013-01-14 |
| Last Update Date | 2017-02-15 |
| 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 | 2138537 | 01 |
| Other Name | Type Code |
|---|---|
| POLK TMC 1 PHCY | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093129124 | Bayne-jones Army Community Hospital | Clinic/Center | 2040 Dragoon Loop, Bldg 1170, Fort Polk, LA 71459-5242 | 2014-06-17 |
| 1669815429 | Bayne-jones Army Community Hospital | Clinic/Center | 8103 Georgia Avenue, Bldg 3516, Ft Polk, LA 71459 | 2013-04-11 |
| 1578891222 | Bayne-jones Army Community Hospital | Clinic/Center | 8097 Georgia Ave, Bldg 3507, Ft Polk, LA 71459 | 2009-11-18 |
| 1619172905 | Bayne-jones Army Community Hospital | Clinic/Center | 1561 Mississippi Street, Fort Polk, LA 71459 | 2007-06-18 |
| 1033218441 | Bayne-jones Army Community Hospital | Military/U.S. Coast Guard Pharmacy | Bldg 1585 3rd St, Bayne Jones Army Community Hosp, Ft Polk, LA 71459 | 2006-09-22 |
| 1841547650 | Bayne-jones Army Community Hospital | Clinic/Center | 8091 Georgia Ave, Bld 3504 Ctmc, Fort Polk, LA 71459-5468 | 2012-08-10 |
| 1609024504 | Bayne-jones Army Community Hospital | Clinic/Center | 1585 3rd St, Chesser Dental Clinic, Fort Polk, LA 71459-5102 | 2008-09-04 |
| 1811192461 | Bayne-jones Army Community Hospital | Clinic/Center | 1585 3rd St, Building 285, Fort Polk, LA 71459-5102 | 2007-06-15 |
| 1104991215 | Bayne-jones Army Community Hospital | Clinic/Center | 1585 Third Street, Fort Polk, LA 71459-6000 | 2006-11-22 |
| Street Address |
8091 GEORGIA AVE BLDG 3504 |
| City | FORT POLK |
| State | LA |
| Zip Code | 71459-5468 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952806986 | Brenda Moore | Dental Hygienist | 7223 Mississippi Ave Building 2157, Fort Polk, LA 71459 | 2018-03-30 |
| 1073017158 | Tiffany Alexander | Dental Assistant | 1561 Mississippi Ave, Ft Polk, LA 71459 | 2018-03-22 |
| 1922524529 | Keith Allan Smiley | Dentist | 7223 Mississippi Avenue Bldg. 1561, Fort Polk, LA 71459 | 2017-08-16 |
| 1336663046 | Alexis Caitlyn Stamm | Specialist/Technologist | 5644 Bazydlo Ct, Fort Polk, LA 71459 | 2017-08-03 |
| 1538615893 | Remedios Macan Dondoyano | Physical Therapist | Bayne-jones Army Community Hospital, 1585 3rd St., Attn: Pt Department, Fort Polk, LA 71459 | 2016-08-28 |
| 1306298997 | Roslyn Faulk | Dental Assistant | 7223 Mississippi Avenut, Frot Polk, LA 71459 | 2016-07-07 |
| 1346691888 | Joy Martin | Dental Hygienist | 7223 Mississippi Avenue, Fort Polk, LA 71459 | 2016-06-27 |
| 1255743936 | Aprille Boudreau | Counselor | 5513 B Gardner Dr., Fort Polk, LA 71459 | 2014-05-29 |
| 1407273170 | Mikaela Diana Mcmanus | Physician Assistant | Building 7318 C Ave G, Fort Polk, LA 71459 | 2014-03-19 |
| 1669815429 | Bayne-jones Army Community Hospital | Clinic/Center | 8103 Georgia Avenue, Bldg 3516, Ft Polk, LA 71459 | 2013-04-11 |
| Find all providers in zip 71459 | ||||
| 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 |
|---|---|---|---|---|
| 1316554645 | Baynes-jones Army Community Hospital | Military/U.S. Coast Guard Pharmacy | 1585 3rd St Bldg 285, Fort Polk, LA 71459-5102 | 2020-09-30 |
| 1447664727 | Bayne Jones Army Community Hospital | Military/U.S. Coast Guard Pharmacy | 1585 3rd St Bldg 285, Bayne Jones Army Community Hospital, Fort Polk, LA 71459-5102 | 2014-06-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033218441 | Bayne-jones Army Community Hospital | Military/U.S. Coast Guard Pharmacy | Bldg 1585 3rd St, Bayne Jones Army Community Hosp, Ft Polk, LA 71459 | 2006-09-22 |
| 1942309356 | New Orleans Nac Phcy | Military/U.S. Coast Guard Pharmacy | 1 Sanctuary Dr Bldg H100, New Orleans, LA 70142-0001 | 2006-09-22 |
| 1467551093 | 2 Nd Medical Group Sgsl | Military/U.S. Coast Guard Pharmacy | Bldg 4709, Barksdale Afb, LA 71110 | 2006-09-21 |
| 1710084561 | Naval Hospital Pensacola | Military/U.S. Coast Guard Pharmacy | 4400 Dauphine St Bldg 601, New Orleans, LA 70146-5609 | 2006-09-20 |
| 1093128282 | Naval Hospital Pensacola | Military/U.S. Coast Guard Pharmacy | 400 Russell Ave Bldg 41, New Orleans, LA 70143-5077 | 2014-06-05 |
| 1538571096 | 2mdss Sgsb | Military/U.S. Coast Guard Pharmacy | 243 Curtiss Rd Ste 100, Barksdale Afb, LA 71110-2425 | 2014-06-02 |
| 1992802748 | 2nd Medical Group Sgsl | Military/U.S. Coast Guard Pharmacy | 243 Curtiss Rd, Ste 100, Barksdale Afb, LA 71110-2425 | 2006-09-20 |
| 1205800109 | 2 Mdss Sgsr | Military/U.S. Coast Guard Pharmacy | 243 Curtiss Rd, Suite 100, Barksdale Afb, LA 71110-2425 | 2006-02-15 |
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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.