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MADIGAN ARMY MEDICAL CTR NPI 1750719761


NPI Information

NPI: 1750719761
Provider Name: MADIGAN ARMY MEDICAL CTR

Doing Business As: PREVENTIVE MEDICINE-JBLM

Classification: Clinic/Center - 261QM1100X
Entity Type: Organization

Specialization: Military/U.S. Coast Guard Outpatient

Address:
5 TH ST BLDG 9025
TACOMA, WA
ZIP 98431
Phone: (253) 968-6103
Get Directions

MADIGAN ARMY MEDICAL CTR is a military/u.s. coast guard outpatient clinic center in Tacoma, WA. The provider is the Defense Health Program or U.S. Coast Guard funded fixed facilities or distinct parts of a facility, providing outpatient medical and dental services, primarily for Uniformed Services beneficiaries. A fixed facility is a non-temporary, non-deployed facility. It includes mobile specialty units such as Magnetic Resonance Imaging (MRI) units that may furnish services at the fixed facility. It includes, as examples, the institutional portion of outpatient encounters (except Ambulatory Procedure Visits), supplies issued (e.g., glasses, ostomy supplies, crutches), and radiology and laboratory studies. Does not include items issued directly to a patient from an outpatient pharmacy or patient transport. MADIGAN ARMY MEDICAL CTR NPI is 1750719761. The provider is registered as an organization entity type.
The provider Is Doing Business As Preventive Medicine-jblm.

The provider's business location address is:

5 TH ST BLDG 9025
TACOMA, WA
ZIP 98431-001
Phone: (253) 968-6103

The provider's authorized official is Karen Mady .
The authorized official title is Tpc Manager and has the following contact phone number (253) 968-6598.

The enumeration date for this NPI number is 10/30/2013 and was last updated on 4/13/2015.


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
1261QM1100XClinic/CenterMilitary/U.S. Coast Guard OutpatientYes

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
1OTH000MEDICARE UPIN
2VAD000MEDICARE UPIN

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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