KENNER ARMY HEALTH CLINIC


Address: Bldg P8130, Ft Lee, VA 23801
Phone: 8047349141

KENNER ARMY HEALTH CLINIC (NPI# 1922107044) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1922107044
Entity Type Organization
Organization Name KENNER ARMY HEALTH CLINIC
Other Organization Name LEE MAIN PHCY
Practice Address Bldg P8130
Ft Lee
VA 23801
Mailing Address Bldg P8130
700 24th St
Ft Lee
VA 23801
Practice Telephone 8047349141
Practice Fax Number 8047349658
Mailing Telephone 8047349141
Mailing Fax Number 8047349658
Enumeration Date 2006-09-22
Last Update Date 2016-04-07
Authorized Official Name HECTOR MORALES (CHIEF DHA PASS)
Authorized Official Telephone 2105366650
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 332000000X Military/U.S. Coast Guard Pharmacy Suppliers

Other Provider Identifier

State Issuer Identifier Type Code
PK 2104460 01

Other Provider/Organization Names

Other Name Type Code
LEE MAIN PHCY Doing Business As Name - Organization

Other Provider IDs and Locations

NPI Name Taxonomy Address Enumeration
1215218342 Kenner Army Health Clinic Clinic/Center 8204 Ave C, Fort Lee, VA 23801-1716 2011-09-02
1982703013 Kenner Army Health Clinic Military/U.S. Coast Guard Pharmacy Bldg 3219, Ft Lee, VA 23801 2006-09-22
1417361866 Kenner Army Health Clinic Military/U.S. Coast Guard Pharmacy 700 24th St Bldg 8130, Kenner Army Health Clinic, Fort Lee, VA 23801-1716 2014-06-13
1043591175 Kenner Army Health Clinic Clinic/Center 700 24th St, Bldg 3219 Ncxo Tmc, Fort Lee, VA 23801-1716 2011-09-02
1497036529 Kenner Army Health Clinic Clinic/Center 2601 C Ave, Tmc 2 Bld T8204, Fort Lee, VA 23801-1717 2011-09-02
1811285034 Kenner Army Health Clinic Military/U.S. Coast Guard Pharmacy 700 24th St, Kenner Army Health Clinic, Fort Lee, VA 23801-1716 2011-07-21
1689879330 Kenner Army Health Clinic Clinic/Center 2601 C Ave, Fort Lee, VA 23801-1717 2007-06-20
1164640504 Kenner Army Health Clinic Clinic/Center 700 24th St, Fort Lee, VA 23801-1716 2007-04-23
1891854014 Kenner Army Health Clinic Clinic/Center 700 24th St, Fort Lee, VA 23801-1716 2006-12-06
1356330641 Kenner Army Health Clinic Clinic/Center 700 24th St, Fort Lee, VA 23801-1716 2005-10-19

Office Location

Street Address BLDG P8130
City FT LEE
State VA
Zip Code 23801

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1790262384 Usv Optical Inc. Eyewear Supplier (Equipment, not the service) Ft. Lee 300 A Ave., Fort Lee, VA 23801 2018-07-26
1770812190 Arkeye Optometrist 300 A Avenue, Bldg 1605, Fort Lee, VA 23801 2009-12-14
1992911044 Claudis Andre' Williams Jr. Physician Assistant 700 24th St., Kenner Army Health Clinic, Ft. Lee, VA 23801 2007-05-15
1982703013 Kenner Army Health Clinic Military/U.S. Coast Guard Pharmacy Bldg 3219, Ft Lee, VA 23801 2006-09-22
1538135157 Laurie Sue Giertz Physician Assistant 700 24th St Apt Hill, Fort Lee, VA 23801 2006-02-24
1689653396 Robert Keith Lather Emergency Medicine Kenner Army Health Clinic, Primary Care Division, Ft Lee, VA 23801 2006-01-11
1265418370 Edward Cathright Jr. Dentist 504 Trenton Drive, Fort Lee, VA 23801 2005-12-20
1801854807 Mack Conley O'quinn Jr. Social Worker 700 24th Street, Kenner Army Health Clinic, Fort Lee, VA 23801 2006-05-02
1083690028 Kimberly Ellen Newton Registered Nurse 700 24th Street, Usameddac Kahc Attn: Credentials Office, Fort Lee, VA 23801 2005-12-21
1619147618 Tahayya A. M Ansari Physician Assistant 700 24th St, Kenner Army Health Clinic, Fort Lee, VA 23801-0030 2008-03-05
Find all providers in zip 23801

Taxonomy Information

Taxonomy Code 332000000X
Grouping Suppliers
Classification Military/U.S. Coast Guard Pharmacy

Taxonomy Definition

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]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1982703013 Kenner Army Health Clinic Military/U.S. Coast Guard Pharmacy Bldg 3219, Ft Lee, VA 23801 2006-09-22

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1174172183 Naval Health Clinic Annapolis Military/U.S. Coast Guard Pharmacy 17457 Caffee Rd Bldg 192, Dahlgren, VA 22448-5120 2019-09-11
1114403961 Naval Medical Center Portsmouth Military/U.S. Coast Guard Pharmacy 7021 Harbor View Blvd, Suffolk, VA 23435-2869 2018-07-16
1437563269 Fort Belvoir Community Hospital Military/U.S. Coast Guard Pharmacy 8651 John J Kingman Rd, Fort Belvoir Community Hospital, Fort Belvoir, VA 22060-6200 2014-06-19
1508270950 Naval Medical Center Portsmouth Military/U.S. Coast Guard Pharmacy 1011 Eden Way N Ste H, Chesapeake, VA 23320-2768 2014-06-13
1205249059 Naval Medical Center Portsmouth Military/U.S. Coast Guard Pharmacy 1647 Admiral Taussig Blvd Bldg Cd2, Norfolk, VA 23511-2803 2014-06-10
1467680819 World Class Marketing Inc Military/U.S. Coast Guard Pharmacy 1814 Kecoughtan Rd, Suite B, Hampton, VA 23661-2834 2009-06-24
1609966936 Naval Medical Center Portsmouth Military/U.S. Coast Guard Pharmacy Naval Weapons Station Yorktown, Bldg 1806, Yorktown, VA 23691-0090 2006-10-16
1659470771 1st Medical Group Sgsl Military/U.S. Coast Guard Pharmacy 65 Spaatz Dr, Langley Afb, VA 23665-2027 2006-09-22
1740389865 Naval Medical Center Portsmouth Military/U.S. Coast Guard Pharmacy 1185 Terrier Ave, Ste 100, Virginia Beach, VA 23461 2006-09-22
1659470797 Us Coast Guard Finance Center Military/U.S. Coast Guard Pharmacy 1 Uscg Training Ctr, Yorktown, VA 23690 2006-09-22
Find all providers with the same taxonomy

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City FT LEE
Zip Code 23801

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Dataset Information

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.

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