NAVAL HEALTH CLINIC ANNAPOLIS (NPI# 1942309364) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1942309364 |
| Entity Type | Organization |
| Organization Name | NAVAL HEALTH CLINIC ANNAPOLIS |
| Practice Address |
250 Wood Rd Annapolis MD 21402-1257 |
| Mailing Address |
695 Kinkaid Road Annapolis MD 21402-1257 |
| Practice Telephone | 4102932406 |
| Practice Fax Number | 4102932820 |
| Mailing Telephone | 4102932406 |
| Mailing Fax Number | 4102932820 |
| Enumeration Date | 2006-09-22 |
| Last Update Date | 2018-04-11 |
| 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 | 2037295 | 01 |
| 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 |
| 1184273195 | Naval Health Clinic Annapolis | Military/U.S. Coast Guard Pharmacy | 4141 W Wilson Rd Bldg 1600, Indian Head, MD 20640-5162 | 2019-09-11 |
| 1801339866 | Naval Health Clinic Annapolis | Pharmacy | 101 Blake Rd, Annapolis, MD 21402-1300 | 2016-11-23 |
| 1346349792 | Naval Health Clinic Annapolis | Military/U.S. Coast Guard Pharmacy | Bmc Bldg 39, Naval Engineering Station, Lakehurst, NJ 08733 | 2006-09-22 |
| 1649682162 | Naval Health Clinic Annapolis | Military/U.S. Coast Guard Pharmacy | 695 Kinkaid Rd, Naval Health Clinic Annapolis, Annapolis, MD 21402 | 2014-06-02 |
| 1528013414 | Naval Health Clinic Annapolis | Clinic/Center | 250 Wood Rd, Annapolis, MD 21402-1257 | 2006-05-23 |
| Street Address |
250 WOOD RD |
| City | ANNAPOLIS |
| State | MD |
| Zip Code | 21402-1257 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629077847 | Jitendrakumar Rajnikant Modi | Pediatrics | 250 Wood Rd, Nhcl Annapolis (pediatrics), Annapolis, MD 21402-1257 | 2005-07-19 |
| 1164776597 | Jennifer Christine Griffeth | Dentist | 250 Wood Rd, Naval Health Clinic Annapolis, Annapolis, MD 21402-1257 | 2012-11-07 |
| 1497004840 | Jan Rainier Anova | Military Health Care Provider | 250 Wood Rd, Annapolis, MD 21402-1257 | 2012-08-30 |
| 1720350135 | Amelia Ross Olson | Physician Assistant | 250 Wood Rd, Annapolis, MD 21402-1257 | 2012-01-31 |
| 1629349394 | John Davod Munyan | Military Health Care Provider | 250 Wood Rd, Annapolis, MD 21402-1257 | 2012-01-26 |
| 1053614891 | Christian Alan Shotwell | Clinical Nurse Specialist | 250 Wood Rd, Annapolis, MD 21402-1257 | 2010-12-17 |
| 1477782480 | Brittany Juree Klass | Optometrist | 250 Wood Rd, Annapolis, MD 21402-1257 | 2009-07-11 |
| 1164578399 | Eileen S Tidd | Internal Medicine | 250 Wood Rd, Annapolis, MD 21402-1257 | 2007-01-29 |
| 1528013414 | Naval Health Clinic Annapolis | Clinic/Center | 250 Wood Rd, Annapolis, MD 21402-1257 | 2006-05-23 |
| 1669439519 | Reginald S. Ewing | Pediatrics | 250 Wood Rd, Annapolis, MD 21402-1257 | 2006-04-26 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427404656 | Karen Ruth Taylor | Social Worker | Usna - Midshipmen Development Center, Bancroft Hall 8m38a, Annapolis, MD 21402 | 2016-05-06 |
| 1710974902 | Ruben Del Pilar | Family Medicine | Naval Health Clinic Annapolis, 250 Wood Road, Annapolis, MD 21402 | 2005-10-03 |
| 1891789137 | Raymond Donald Chronister | Specialist/Technologist | Physical Education, Field House, U. S. Naval Academy, Annapolis, MD 21402 | 2005-09-01 |
| 1649682162 | Naval Health Clinic Annapolis | Military/U.S. Coast Guard Pharmacy | 695 Kinkaid Rd, Naval Health Clinic Annapolis, Annapolis, MD 21402 | 2014-06-02 |
| 1619303484 | Melanie Cooper Carmody | Pharmacist | 250 Wood Road, Nhc Annapolis, Annapolis, MD 21402 | 2013-09-24 |
| 1770599060 | Collette Stevenson | Dental Hygienist | 250 Wood Road, Naval Health Clinic, Annapolis, MD 21402 | 2006-07-31 |
| 1447272505 | Michelle M. Decker | Dental Hygienist | 250 Wood Road, Naval Health Clinic, Annapolis, MD 21402 | 2006-07-24 |
| 1851313936 | Eunice Smith | Dental Hygienist | 250 Wood Road, Naval Health Clinic, Annapolis, MD 21402 | 2006-07-24 |
| 1316229701 | Shields Vision | Optometrist | 321 Kinkaid Rd, Building 329, Annapolis, MD 21402-1002 | 2011-09-13 |
| 1124259718 | Anchor Eyecare Annapolis | Optometrist | 321 Kinkaid Rd, Building 329, Annapolis, MD 21402-1002 | 2009-07-31 |
| Find all providers in zip 21402 | ||||
| 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 |
|---|---|---|---|---|
| 1548868870 | Walter Reed National Military Medical Center | Military/U.S. Coast Guard Pharmacy | 101 Buchanan Rd, Annapolis, MD 21402-5107 | 2020-10-09 |
| 1649682162 | Naval Health Clinic Annapolis | Military/U.S. Coast Guard Pharmacy | 695 Kinkaid Rd, Naval Health Clinic Annapolis, Annapolis, MD 21402 | 2014-06-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184273195 | Naval Health Clinic Annapolis | Military/U.S. Coast Guard Pharmacy | 4141 W Wilson Rd Bldg 1600, Indian Head, MD 20640-5162 | 2019-09-11 |
| 1063763241 | National Naval Medical Center | Military/U.S. Coast Guard Pharmacy | 8901 Wisconsin Ave Dept Ofphcy, Bldg 9, Room 2303, Bethesda, MD 20889-0001 | 2012-09-27 |
| 1902905318 | Naval Health Clinic Patuxent River | Military/U.S. Coast Guard Pharmacy | Bldg 1370, Patuxent River, MD 20670 | 2006-09-22 |
| 1679672083 | Dunham Army Health Clinic | Military/U.S. Coast Guard Pharmacy | 1452 Porter St, Ft Detrick, MD 21702 | 2006-09-22 |
| 1851490270 | Malcom Grow Medical Center 79 Mdg Mdss Sgsr | Military/U.S. Coast Guard Pharmacy | 1050 W Perimeter Rd # D1119, Jb Andrews, MD 20762-6601 | 2006-09-22 |
| 1174620926 | Naval Health Clinic Patuxent River | Military/U.S. Coast Guard Pharmacy | Bldg 1600 Wilson Drive, Indian Head, MD 20640 | 2006-09-20 |
| 1265539019 | Malcom Grow Medical Center 79 Mdg Mdss Sgsr | Military/U.S. Coast Guard Pharmacy | 1 San Diego Loop Bldg 3188, Jb Andrews, MD 20762-5518 | 2006-09-20 |
| 1205242310 | Kimbrough Acc Military Mtf | Military/U.S. Coast Guard Pharmacy | 1434 Porter St, Frederick, MD 21702-9254 | 2014-07-09 |
| 1518379395 | Malcolm Grow Medical Clinic 779 Mdg | Military/U.S. Coast Guard Pharmacy | 1060 W Perimeter Rd, Joint Base Andrews, MD 20762-6602 | 2014-05-28 |
| 1417369299 | Kimbrough Acc Military Mtf | Military/U.S. Coast Guard Pharmacy | Kirk U.S. Army Health Clinic, Bldg. 2501 Oakington Street, Aberdeen Proving Ground, MD 21005-5163 | 2014-05-28 |
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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.