MCDONALD ARMY HEALTH CENTER (NPI# 1992933279) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1992933279 |
| Entity Type | Organization |
| Organization Name | MCDONALD ARMY HEALTH CENTER |
| Other Organization Name | EUSTIS TMC 2 PHCY |
| Practice Address |
815 Gaffey Pl Fort Eustis VA 23604-1505 |
| Mailing Address |
Mcdonald Army Health Center Attn Ubo 579 Jefferson Ave Ft Eustis VA 23604 |
| Practice Telephone | 7573147654 |
| Practice Fax Number | 7573147764 |
| Mailing Telephone | 7573147654 |
| Mailing Fax Number | 7573147764 |
| Enumeration Date | 2009-06-25 |
| Last Update Date | 2015-06-18 |
| 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 | 2120808 | 01 |
| Other Name | Type Code |
|---|---|
| EUSTIS TMC 2 PHCY | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821294729 | Mcdonald Army Health Center | Clinic/Center | Building 82 Ingals, Fort Monroe, VA 23651 | 2007-06-26 |
| 1659577534 | Mcdonald Army Health Center | Clinic/Center | Building 576 Stemberg Avenue, Fort Eustis, VA 23604 | 2007-06-26 |
| 1508062779 | Mcdonald Army Health Center | Clinic/Center | Building 669 Monroe Avenue, Fort Eustis, VA 23604 | 2007-06-25 |
| 1922199066 | Mcdonald Army Health Center | Clinic/Center | 579 Jefferson Ave, Fort Eustis, VA 23604 | 2006-09-27 |
| 1386743409 | Mcdonald Army Health Center | Pharmacy | Ingalls Rd Bldg 82, Ft Monroe, VA 23651 | 2006-09-22 |
| 1124127246 | Mcdonald Army Health Center | Military/U.S. Coast Guard Pharmacy | 576 Jefferson Ave Rm J7, Fort Eustis, VA 23604-1373 | 2006-09-22 |
| 1134226988 | Mcdonald Army Health Center | Military/U.S. Coast Guard Pharmacy | 649 New Guinea Rd, Ft Story, VA 23459 | 2006-09-20 |
| 1609339340 | Mcdonald Army Health Center | Military/U.S. Coast Guard Pharmacy | 5309 Discovery Park Blvd, Williamsburg, VA 23188-2789 | 2019-04-10 |
| 1861807703 | Mcdonald Army Health Center | Military/U.S. Coast Guard Pharmacy | 576 Jefferson Ave, Fort Eustis, VA 23604-1373 | 2014-06-30 |
| 1528295318 | Mcdonald Army Health Center | Clinic/Center | 664 Darcy Pl, Fort Eustis, VA 23604-1635 | 2009-06-18 |
| Street Address |
815 GAFFEY PL |
| City | FORT EUSTIS |
| State | VA |
| Zip Code | 23604-1505 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487682290 | Susan Kaye Moore | Nurse Practitioner | 815 Gaffey Pl, Fort Eustis, VA 23604-1505 | 2006-06-29 |
| 1336617349 | Johnathan Matthew Taylor | Nurse Practitioner | 815 Gaffey Pl, Fort Eustis, VA 23604-1505 | 2018-11-07 |
| 1528295615 | Mcdonald Army Health Center | Clinic/Center | 815 Gaffey Pl, Fort Eustis, VA 23604-1505 | 2009-06-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194375188 | Vincent Nevin Lattanzi | Dental Assistant | 576 Fort Eustis Blvd, Fort Eustis, VA 23604 | 2019-09-12 |
| 1730531872 | Steven Mansion | Dental Assistant | Bldg 669 Monroe Ave, Fort Eustis, VA 23604 | 2016-07-12 |
| 1497106140 | Cindy Delapena | Dental Hygienist | 577 Sternberg Avenue, Usa Dental Activity Headquarters, Fort Eustis, VA 23604 | 2016-06-23 |
| 1073990131 | Usv Optical Inc | Eyewear Supplier (Equipment, not the service) | 1386 Washington Blvd, Fort Eustis, VA 23604 | 2015-04-28 |
| 1548529985 | Sunland Optical Co., Inc. | Eyewear Supplier (Equipment, not the service) | Bldg. 1386, Fort Eustis, VA 23604 | 2012-05-04 |
| 1073708335 | Heather Dawn Guntherberg | Pharmacist | Mcdonald Army Health Clinic, Bldg 576 Jefferson Ave, Fpo, AE 23604 | 2007-09-10 |
| 1659577534 | Mcdonald Army Health Center | Clinic/Center | Building 576 Stemberg Avenue, Fort Eustis, VA 23604 | 2007-06-26 |
| 1508062779 | Mcdonald Army Health Center | Clinic/Center | Building 669 Monroe Avenue, Fort Eustis, VA 23604 | 2007-06-25 |
| 1922161157 | Kimberly Sue Strubhar | Licensed Practical Nurse | Harrison Loop, Building 2792a, Fort Eustiis, VA 23604 | 2006-12-19 |
| 1972666287 | Nkechi Trudy Ekwueme | Licensed Practical Nurse | Bldg 576 Jefferson Ave, Fort Eustis, VA 23604 | 2006-12-18 |
| Find all providers in zip 23604 | ||||
| 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 |
|---|---|---|---|---|
| 1124127246 | Mcdonald Army Health Center | Military/U.S. Coast Guard Pharmacy | 576 Jefferson Ave Rm J7, Fort Eustis, VA 23604-1373 | 2006-09-22 |
| 1861807703 | Mcdonald Army Health Center | Military/U.S. Coast Guard Pharmacy | 576 Jefferson Ave, Fort Eustis, VA 23604-1373 | 2014-06-30 |
| 1609975739 | Mcdonald Army Health Center | Military/U.S. Coast Guard Pharmacy | 576 Jefferson Ave, Fort Eustis, VA 23604-1373 | 2006-09-22 |
| 1477652592 | Mcdonald Army Health Center | Military/U.S. Coast Guard Pharmacy | 576 Jefferson Ave, Room 34, Fort Eustis, VA 23604-1373 | 2006-09-22 |
| 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 |
| 1982703013 | Kenner Army Health Clinic | Military/U.S. Coast Guard Pharmacy | Bldg 3219, Ft Lee, VA 23801 | 2006-09-22 |
| 1922107044 | Kenner Army Health Clinic | Military/U.S. Coast Guard Pharmacy | Bldg P8130, Ft Lee, VA 23801 | 2006-09-22 |
| 1659470771 | 1st Medical Group Sgsl | Military/U.S. Coast Guard Pharmacy | 65 Spaatz Dr, Langley Afb, VA 23665-2027 | 2006-09-22 |
| Find all providers with the same taxonomy | ||||
| City | FORT EUSTIS |
| Zip Code | 23604 |
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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.