BRANCH MEDICAL CLINIC GUAM (NPI# 1770789331) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770789331 |
| Entity Type | Organization |
| Organization Name | BRANCH MEDICAL CLINIC GUAM |
| Practice Address |
Building 6 Chapel Road Santa Rita GU 96538 |
| Mailing Address |
Psc 455 Box 208 Fpo AP 96540-0003 |
| Practice Telephone | 6713397118 |
| Mailing Telephone | 6713449242 |
| Enumeration Date | 2007-06-21 |
| Last Update Date | 2018-04-09 |
| Authorized Official Name | WILLIAM M CONDON (BUMED UBO) |
| Authorized Official Telephone | 2404013643 |
| Is Organization Subpart | Y |
| Parent Organization Name | NAVAL HOSPITAL GUAM |
| 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 |
| Street Address |
BUILDING 6 CHAPEL ROAD |
| City | SANTA RITA |
| State | GU |
| Zip Code | 96538 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326471731 | Kutistia Diane Ragland | Radiologic Technologist | Psc 490 Bx 7716, Fpo, AP 96538 | 2013-08-21 |
| 1437593209 | Blaed Jacob Gerhart | Physician Assistant | 1 Farenholt St, Bldg K-1, Fpo, AP 96538 | 2013-04-24 |
| 1568658482 | Dexter Dancel Cabral | Military Health Care Provider | Psc 490 Box 7607, Fpo, AP 96538 | 2007-09-25 |
| 1023084738 | Leslie A Boone | Occupational Therapist | Box 9095, Fpo, AP 96538 | 2006-02-23 |
| 1093786048 | Jason Matthew Jones | Audiologist | Psc 490 Box 7732, Fpo, AP 96538 | 2006-01-29 |
| 1215917893 | Ik Jo Ahn | Anesthesiology | Psc 490, Box 9095, Fpo, AP 96538 | 2006-01-19 |
| 1841270881 | Jamie Metcalf Daut | Audiologist | Pcs 490 Box 7723, Fpo, AP 96538 | 2006-01-17 |
| 1992784052 | Donna Marie Hunter | Dietitian, Registered | Psc 490 Box 9095, Fpo, AP 96538 | 2006-01-17 |
| 1548249600 | Ethel Doreen Tomasi | Social Worker | Psc 490 Box 7704, Fpo, AP 96538 | 2006-01-16 |
| 1689653735 | Elizabeth M. Adriano | Obstetrics & Gynecology | Usnh Guam--obgyn Dept, Psc 490 Box 9025, Fpo, AP 96538 | 2006-01-16 |
| Find all providers in zip 96538 | ||||
| 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] |
| City | SANTA RITA |
| Zip Code | 96538 |
Please comment or provide details below to improve the information on BRANCH MEDICAL CLINIC GUAM.
| 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.