NPIMap

Organization Active NPI

Madigan Army Medical Ctr

Doing business as 4/2 Ebh Clinic-JBLM

  • Military/U.S. Coast Guard Outpatient Clinic/Center
  • Tacoma, WA
National Provider Identifier
1376974303
Registry record updated Apr 13, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Military/U.S. Coast Guard Outpatient Clinic/CenterTaxonomy code 261QM1100X
Legal business name
MADIGAN ARMY MEDICAL CTR
Doing business as
4/2 Ebh Clinic-JBLM
Practice address
3 Rd Division Dr BLDG R3150
Tacoma, WA 98431-0001
Phone
(253) 967-7337
NPI assigned
Dec 2, 2013
Last updated
Apr 13, 2015By the provider in NPPES
Organization subpart
Yes
Parent organization
MADIGAN ARMY MEDICAL CTRAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 13, 2015

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

Authorized official

Name
Karen Mady
Title
TPC Manager
Phone
(253) 968-6598

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Military/U.S. Coast Guard Outpatient Clinic/Center 261QM1100X NU Primary

Addresses

Primary practice location

3 Rd Division Dr BLDG R3150
Tacoma, WA 98431-0001

Mailing address

9040A Jackson Ave
Attn: MCHJ-Csa-U
Tacoma, WA 98431-0001
Phone (253) 968-6598

Other names 1

  • 4/2 EBH CLINIC-JBLM Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Madigan Army Medical Center33 organizations share this tax ID, including this one
Part of
Madigan Army Medical Center

Other organizations with this tax ID 32

Organizations that report the same tax identification number in the National Provider Directory.

View all 32

Locations

3 Rd Division Dr
Bldg R3150
Tacoma, WA 98431
Phone (253) 967-7337

NPI Registry JSON

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

{
    "created_epoch": "1385942400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1428883200000",
    "number": "1376974303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9040A JACKSON AVE",
            "address_2": "ATTN: MCHJ-CSA-U",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984310001",
            "telephone_number": "253-968-6598"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 RD DIVISION DR BLDG R3150",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984310001",
            "telephone_number": "253-967-7337"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MADIGAN ARMY MEDICAL CTR",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MADIGAN ARMY MEDICAL CTR",
        "enumeration_date": "2013-12-02",
        "last_updated": "2015-04-13",
        "status": "A",
        "authorized_official_last_name": "MADY",
        "authorized_official_first_name": "KAREN",
        "authorized_official_title_or_position": "TPC MANAGER",
        "authorized_official_telephone_number": "253-968-6598"
    },
    "taxonomies": [
        {
            "code": "261QM1100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Military/U.S. Coast Guard Outpatient",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "4/2 EBH CLINIC-JBLM",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tacoma, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2015; 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.