WILLIAM BEAUMONT ARMY MEDICAL CENTER (NPI# 1962718726) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962718726 |
| Entity Type | Organization |
| Organization Name | WILLIAM BEAUMONT ARMY MEDICAL CENTER |
| Other Organization Name | BLISS PX PHCY |
| Practice Address |
Haan Rd Ste A-11 Bldg 1611 Ft Bliss TX 79916 |
| Practice Telephone | 9155693095 |
| Practice Fax Number | 9155694271 |
| Mailing Telephone | 9155693095 |
| Mailing Fax Number | 9155694271 |
| Enumeration Date | 2010-08-31 |
| Last Update Date | 2010-08-31 |
| Authorized Official Name | MR. HECTOR MORALES (DEPUTY DIRECTOR PHCY OPS CTR) |
| Authorized Official Telephone | 2102218443 |
| Is Organization Subpart | Y |
| Parent Organization Name | WILLIAM BEAUMONT ARMY MEDICAL CENTER |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332000000X | Military/U.S. Coast Guard Pharmacy | Suppliers |
| Other Name | Type Code |
|---|---|
| BLISS PX PHCY | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326527177 | William Beaumont Army Medical Center | Clinic/Center | 11291 Sgt E Churchill St, Fort Bliss, TX 79918-8001 | 2018-08-13 |
| 1952716896 | William Beaumont Army Medical Center | Military/U.S. Coast Guard Pharmacy | 1363 Aberdeen Road, White Sands Missile Range, NM 88002-5520 | 2014-06-30 |
| 1629322144 | William Beaumont Army Medical Center | Clinic/Center | Torch St Bldg 21227, Dental Clinic, Fort Bliss, TX 79916 | 2012-11-06 |
| 1366796880 | William Beaumont Army Medical Center | Clinic/Center | Bldg 21227 Torch Street, Fort Bliss, TX 79916 | 2012-11-06 |
| 1134479413 | William Beaumont Army Medical Center | Military/U.S. Coast Guard Pharmacy | Torch St Rm C101, Bldg 21227, Ft Bliss, TX 79916 | 2012-09-14 |
| 1316253297 | William Beaumont Army Medical Center | Military/U.S. Coast Guard Pharmacy | Hawk Rd, Rm 9503-11, Chaparrel, NM 88021 | 2010-08-30 |
| 1649476474 | William Beaumont Army Medical Center | Clinic/Center | Bldg 11281, Biggs Dental Clinic, Ft Bliss, TX 79920 | 2007-06-27 |
| 1629274105 | William Beaumont Army Medical Center | Clinic/Center | 525 Rock Island, White Sands, NM 88002 | 2007-06-22 |
| 1467667287 | William Beaumont Army Medical Center | Clinic/Center | Ricker Road Bldg 2496, Sfmc, Fort Bliss, TX 79920 | 2007-05-14 |
| 1669687489 | William Beaumont Army Medical Center | Clinic/Center | Ssg Sims Street Bldg 11335, Mendoza Soldier Family Care Clinic, El Paso, TX 79920 | 2007-05-14 |
| Street Address |
HAAN RD STE A-11 BLDG 1611 |
| City | FT BLISS |
| State | TX |
| Zip Code | 79916 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730717042 | James Cain | Dietitian, Registered | Fort Bliss, El Paso, TX 79916 | 2020-03-31 |
| 1477190783 | Daryl E. Stevens Sr. | Social Worker | 2415 Carrington Rd, El Paso, TX 79916 | 2019-12-05 |
| 1427518901 | Danielle Hicks | Physician Assistant | 2496 Ricker Rd., El Paso, TX 79916 | 2019-03-21 |
| 1306327796 | Dustin Tyler Nygard | Dentist | East Bliss Dental Clinic, 21227 Torch St, Ft. Bliss, TX 79916 | 2018-08-24 |
| 1558886911 | Aaron M Lazuka | Dentist | Bldg 128 Chaffe Rd., Fort Bliss, TX 79916 | 2017-08-07 |
| 1487100012 | Cristina Martinez Madison | Dental Assistant | 2954 Carrington Rd, Fort Bliss, TX 79916 | 2016-09-01 |
| 1932559689 | Regina Vernetta Adamson | Dental Assistant | Bldg 128 Chaffee Road, Attn: Dentac Headquarters Us Army Dental Activity, Ft Bliss, TX 79916 | 2016-06-14 |
| 1760832471 | Yvonne Melton | Dental Hygienist | Us Army Dental Activity Bldg 128 Chaffee Road, Attn: Dentac Headquareters, Ft Bliss, TX 79916 | 2016-06-14 |
| 1780034405 | John Franklin Caswell | Dental Hygienist | Us Army Dental Activity, Bldg 128 Chaffee Road, Attn: Dentac Headquarters, Ft Bliss, TX 79916 | 2016-06-14 |
| 1073999231 | Martha Villafrade-blume | Social Worker | 2485 A Hinman Road, Fort Bliss, TX 79916 | 2015-08-10 |
| Find all providers in zip 79916 | ||||
| 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 |
|---|---|---|---|---|
| 1134479413 | William Beaumont Army Medical Center | Military/U.S. Coast Guard Pharmacy | Torch St Rm C101, Bldg 21227, Ft Bliss, TX 79916 | 2012-09-14 |
| 1447434782 | William Beaumont Army Medical | Military/U.S. Coast Guard Pharmacy | Biggs Army Airfield, Bldg 11281, Ft Bliss, TX 79918 | 2007-12-21 |
| 1780783845 | William Beaumont Army Medical | Military/U.S. Coast Guard Pharmacy | Bldg 1735, Ft Bliss, TX 79916 | 2006-09-22 |
| 1811096969 | William Beaumont Army Medical | Military/U.S. Coast Guard Pharmacy | Bldg 2496, Ft Bliss, TX 79916 | 2006-09-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710532510 | Brooke Army Medical Center | Military/U.S. Coast Guard Pharmacy | 7800 W Ih 10 Ste 235, San Antonio, TX 78230-4768 | 2019-08-08 |
| 1508364258 | Wilford Hall Medical Center | Military/U.S. Coast Guard Pharmacy | 25615 Us Highway 281 N Ste 215, San Antonio, TX 78258-7135 | 2018-01-29 |
| 1831502590 | Brooke Army Medical Center | Military/U.S. Coast Guard Pharmacy | 2401 Scott Rd, Brooke Army Medical Center, Fort Sam Houston, TX 78234 | 2014-06-10 |
| 1124431317 | Carl R. Darnall Army Medical Center | Military/U.S. Coast Guard Pharmacy | 4250 Clear Creek Rd, Room 406, Fort Hood, TX 76544-5095 | 2014-06-05 |
| 1053618546 | Brooke Army Medical Center | Military/U.S. Coast Guard Pharmacy | 6501 Fm 3009, Suite 210, Schertz, TX 78154 | 2011-02-17 |
| 1740580125 | Carl R Darnall Army Medical Center | Military/U.S. Coast Guard Pharmacy | 458 W Highway 190, Town Square Shopping Center, Copperas Cove, TX 76522-3904 | 2010-11-01 |
| 1477853851 | Carl R Darnall Army Medical Center | Military/U.S. Coast Guard Pharmacy | Market Heights Shopping Center 201 E., Central Texas Expressway, Harker Heights, TX 76548 | 2010-11-01 |
| 1891003000 | Carl R Darnall Amry Medical Center | Military/U.S. Coast Guard Pharmacy | 2245 761st Tank Bn, Bldg 2245, Fort Hood, TX 76544 | 2010-09-22 |
| 1902117187 | Brooke Army Medical Center | Military/U.S. Coast Guard Pharmacy | 1300 Schofield Rd, Bldg 1179, San Antonio, TX 78234 | 2010-06-23 |
| 1306160973 | 359th Mdg | Military/U.S. Coast Guard Pharmacy | 630 3rd St W, Bldg 1068, Randolph Afb, TX 78150-4804 | 2010-03-25 |
| Find all providers with the same taxonomy | ||||
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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.