EBH5-FT. CAMPBELL – NPI #1659785053
Clinic/Center

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.

EBH5-FT. CAMPBELL is an AHC clinic located in FORT CAMPBELL, KY. NPPES has assigned the NPI number 1659785053 to EBH5-FT. CAMPBELL on June 13, 2014. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “EBH5-FT. CAMPBELL” is a dba name, the actual legal business name for this organization is BLANCHFIELD ARMY COMMUNITY HOSPITAL. The primary taxonomy selected by this provider is 261QM1100X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center, specializing in Military/U.S. Coast Guard Outpatient

Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for EBH5-FT. CAMPBELL below.

NPI Profile for
BLANCHFIELD ARMY COMMUNITY HOSPITAL

NPI Number
1659785053
Enumeration Date

(about 12 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
BLANCHFIELD ARMY COMMUNITY HOSPITAL
Doing Business As (dba): EBH5-FT. CAMPBELL
Primary location
BLDG 6747 A SHAU VALLEY ROAD
FORT CAMPBELL, KY 42223
Phone: (270) 798-8967 Fax:
Mailing address
650 JOEL DR
ATTN UBO
FORT CAMPBELL, KY 42223-5318
Phone: (270) 798-8286 Fax:
Organization Subpart
Yes - EBH5-FT. CAMPBELL is subpart of another organization.
Authorized Official
CHAD HALE
ACTING UBO MANAGER
Phone: (270) 798-8286
Updated
Identifiers

Identifiers for EBH5-FT. CAMPBELL

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

DescriptionIssuerStateIdentifier
OTHERPARENT FACILITY BLANCHFIELD ARMY COMMUNITY HOSPITAL NPI 21417044702
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
261QM1100X
- Clinic/Center / Military/U.S. Coast Guard Outpatient (Primary)

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.