NPIMap

Organization Active NPI

USA Meddac, Rwbahc

  • Primary Care Clinic/Center
  • Ft. Huachuca, AZ
National Provider Identifier
1124486840
Registry record updated Feb 9, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
LP 00041579 Issued in WA
Legal business name
USA MEDDAC, RWBAHC
Practice address
2240 E Winrow Ave
USA Meddac, Rwbahc
Ft. Huachuca, AZ 85613
Phone
(520) 533-9034
Fax
(520) 533-5148
NPI assigned
Feb 9, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Ms. Carol Jean Phillips
Title
LPN
Phone
(520) 533-9034

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X LP 00041579 WA Primary

Addresses

Primary practice location

2240 E Winrow Ave
USA Meddac, Rwbahc
Ft. Huachuca, AZ 85613

Mailing address

2240 Winrow Ave
Ft.Huachuca, AZ 85613-7079
Phone (520) 533-9034

National Provider Directory

National Provider Directory
Tax ID family
McDonald Army Health Care Center200 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 13

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 13

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1454976000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1454976000000",
    "number": "1124486840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2240 WINROW AVE",
            "city": "FT.HUACHUCA",
            "state": "AZ",
            "postal_code": "856137079",
            "telephone_number": "520-533-9034",
            "fax_number": "520-533-5148"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2240 E WINROW AVE",
            "address_2": "USA MEDDAC, RWBAHC",
            "city": "FT. HUACHUCA",
            "state": "AZ",
            "postal_code": "85613",
            "telephone_number": "520-533-9034",
            "fax_number": "520-533-5148"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "USA MEDDAC, RWBAHC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-09",
        "last_updated": "2016-02-09",
        "status": "A",
        "authorized_official_last_name": "PHILLIPS",
        "authorized_official_first_name": "CAROL",
        "authorized_official_middle_name": "JEAN",
        "authorized_official_title_or_position": "LPN",
        "authorized_official_telephone_number": "520-533-9034",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "WA",
            "license": "LP 00041579",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ft. Huachuca, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.