NPIMap

Organization Active NPI

USA Meddac, Rwbahc

  • Health Service Clinic/Center
  • Fort Huachuca, AZ
National Provider Identifier
1356700801
Registry record updated Feb 12, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Service Clinic/CenterTaxonomy code 261QH0100X
License
PN5193793 Issued in FL
Legal business name
USA MEDDAC, RWBAHC
Practice address
2240 Winrow Ave
Fort Huachuca, AZ 85613
Phone
(520) 533-9034
NPI assigned
Feb 12, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2016

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

Authorized official

Name
Crystal Quintana, LPN
Title
Licensed Practical Nurse
Phone
(520) 533-9034

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health Service Clinic/Center 261QH0100X PN5193793 FL Primary

Addresses

Primary practice location

2240 Winrow Ave
Fort Huachuca, AZ 85613

Mailing address

2240 Winrow Ave
Fort Huachuca, AZ 85613

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 15

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

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1455235200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1455235200000",
    "number": "1356700801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2240 WINROW AVE",
            "city": "FORT HUACHUCA",
            "state": "AZ",
            "postal_code": "85613"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2240 WINROW AVE",
            "city": "FORT HUACHUCA",
            "state": "AZ",
            "postal_code": "85613",
            "telephone_number": "520-533-9034"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "USA MEDDAC, RWBAHC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-12",
        "last_updated": "2016-02-12",
        "status": "A",
        "authorized_official_last_name": "QUINTANA",
        "authorized_official_first_name": "CRYSTAL",
        "authorized_official_title_or_position": "LICENSED PRACTICAL NURSE",
        "authorized_official_telephone_number": "520-533-9034",
        "authorized_official_credential": "LPN"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "FL",
            "license": "PN5193793",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Huachuca, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 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.