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KIMBROUGH ACC MILITARY MTF NPI 1437563871


NPI Information

NPI: 1437563871
Provider Name: KIMBROUGH ACC MILITARY MTF

Doing Business As: DOD FT MEADE EPHCY

Classification: Military/U.S. Coast Guard Pharmacy - 332000000X
Entity Type: Organization
Address:
2480 LLEWELLYN AVE STE 5800
KIMBROUGH AMBULATORY CARE CENTER
FORT MEADE, MD
ZIP 20755
Phone: (301) 677-8800
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KIMBROUGH ACC MILITARY MTF is a military us coast guard pharmacy in Fort Meade, MD. The provider is 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. KIMBROUGH ACC MILITARY MTF NPI is 1437563871. The provider is registered as an organization entity type.
The provider Is Doing Business As Dod Ft Meade Ephcy.

The provider's business location address is:

2480 LLEWELLYN AVE STE 5800
KIMBROUGH AMBULATORY CARE CENTER
FORT MEADE, MD
ZIP 20755-129
Phone: (301) 677-8800
Fax: (301) 677-8456

The provider's authorized official is Hector Morales .
The authorized official title is Chief Dha Pass and has the following contact phone number (210) 536-6650.

The enumeration date for this NPI number is 6/13/2014 and was last updated on 3/21/2023.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1333600000XPharmacyNo
2332000000XMilitary/U.S. Coast Guard PharmacyYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
12146217OTHERPK

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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