Organization
ACH BLANCHFIELD-FT CAMPBELL
Active
Organization
ACH BLANCHFIELD-FT CAMPBELL
Active
Parent organization
ACH BLANCHFIELD-FT CAMPBELL
Organization subpart
Yes
Provider details
NPI number
Legal business name
ACH BLANCHFIELD-FT CAMPBELL
Authorized official
MS. SHARON L TUCKER (UBO MANAGER)
(270) 798-8286
Entity
Organization
Contact information
Practice address
650 JOEL DR, FORT CAMPBELL, KY 42223-5318
(270) 798-8286
(270) 798-8286
Mailing address
650 JOEL DR, ATTN UBO, FORT CAMPBELL, KY 42223-5318
(270) 798-8286
(270) 956-0450
Taxonomy
Speciality
Code
Description
License number
State
261QM1100X
Military/U.S. Coast Guard Outpatient Clinic/Center
—
—
261QM1101X
Military and U.S. Coast Guard Ambulatory Procedure Clinic/Center
—
—
2865M2000X
Military General Acute Care Hospital
Primary
—
—
332000000X
Military/U.S. Coast Guard Pharmacy
—
—
341800000X
Military/U.S. Coast Guard Transport
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000054923
ANTHEM BLUE CROSS & BLUE
—
01
—
000000250244
ANTHEM BLUE CROSS & BLUE
—
01
—
1825946
NCPDP
—
01
—
AN2598588
MEDCO
—
Enumeration date
10/06/2006
Last updated
05/21/2025
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