Organization Active NPI

Guthrie Ahc

Doing business as EBH 3rd BCT CLINIC-DRUM

  • Military/U.S. Coast Guard Outpatient Clinic/Center
  • Fort Drum, NY
National Provider Identifier
1962823575
Registry record updated Apr 20, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Military/U.S. Coast Guard Outpatient Clinic/CenterTaxonomy code 261QM1100X
Legal business name
GUTHRIE AHC
Doing business as
EBH 3rd BCT CLINIC-DRUM
Practice address
11050 Mount Beledere Blvd
Fort Drum, NY 13602
Phone
(315) 772-0977
NPI assigned
Dec 27, 2013
Organization subpart
Yes
Parent organization
GUTHRIE AHCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 20, 2015

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

Authorized official

Name
Nancy Draper
Title
Acting Ubo Manager
Phone
(315) 772-1755

Specialties & licenses 1

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

Addresses

Primary practice location

11050 Mount Beledere Blvd
Fort Drum, NY 13602

Mailing address

11050 Mount Belvedere Blvd
C/O Ubo
Fort Drum, NY 13602-5438
Phone (315) 772-4033

Other names 1

  • EBH 3rd BCT CLINIC-DRUM Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Guthrie Ahc13 organizations share this tax ID, including this one
Part of
Guthrie Ahc

Other organizations with this tax ID 12

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

NPI Registry JSON

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

{
    "created_epoch": "1388102400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1429488000000",
    "number": "1962823575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11050 MOUNT BELVEDERE BLVD",
            "address_2": "C/O UBO",
            "city": "FORT DRUM",
            "state": "NY",
            "postal_code": "136025438",
            "telephone_number": "315-772-4033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11050 MOUNT BELEDERE BLVD",
            "city": "FORT DRUM",
            "state": "NY",
            "postal_code": "13602",
            "telephone_number": "315-772-0977"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GUTHRIE AHC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GUTHRIE AHC",
        "enumeration_date": "2013-12-27",
        "last_updated": "2015-04-20",
        "status": "A",
        "authorized_official_last_name": "DRAPER",
        "authorized_official_first_name": "NANCY",
        "authorized_official_title_or_position": "ACTING UBO MANAGER",
        "authorized_official_telephone_number": "315-772-1755"
    },
    "taxonomies": [
        {
            "code": "261QM1100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Military/U.S. Coast Guard Outpatient",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "EBH 3rd BCT CLINIC-DRUM",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fort Drum, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 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.