MEDICARE: KELLER ARMY COMMUNITY HOSPITAL

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QM1100X	Military/U.S. Coast Guard Outpatient Clinic/Center

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1528161916	OTHER		PARENT FACILITY NPI

General Provider Information

NPI Number	:	1134333883
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KELLER ARMY COMMUNITY HOSPITAL

Provider Business Mailing Address
First Line	:	900 WASHINGTON RD
Second Line	:	ATTN: MCUD-RMD-UBO
City	:	WEST POINT
State	:	NY
Zip	:	10996-1109
Country	:	US
Telephone Number	:	845-938-8239
Fax Number	:

Provider Business Practice Location Address
First Line	:	114 WHITE AVE
Second Line	:
City	:	FORT HAMILTON
State	:	NY
Zip	:	11252-9503
Country	:	US
Telephone Number	:	718-630-4611
Fax Number	:

Authorized Official
Title or Position	:	UBO MANAGER
Name	:	KENNETH TUFFY
Credential	:
Telephone Number	:	845-938-8239

Provider Enumeration Date	:	05/10/2007
Last Update Date	:	06/16/2014

Similar Medicare Providers

1225029226 — MR. JEFFREY MNI PERLES MSW
Practice Location Address:

FORT HAMILTON ARMY BASE , BLDG #114 RM 1-19
BROOKLYN, NY
11252-6530

Practice Phone: 718-630-4915
Practice Fax: 718-630-4941

1407837222 — NELLY FUZAYLOV RPH
Practice Location Address:

AINSWORTH US ARMY HEALTH CLINIC PHARMACY , AINSWORTH US ARMY HEALTH CLINIC BLDG 114
FORT HAMILTON, NY
11252-6500

Practice Phone: 718-630-4268
Practice Fax: 718-630-4337

1912487174 — WALTER DWAIN WARE JR.
Practice Location Address:

4201 STONEGATE BLVD
FORT WORTH, TX
76109-9503

Practice Phone: 817-924-5440
Practice Fax:

1740760800 — STEVE HINOJOSA OTA
Practice Location Address:

4201 STONEGATE BLVD
FORT WORTH, TX
76109-9503

Practice Phone: 817-924-5440
Practice Fax:

1952881062 — MRS. BLANCA IVETTE MANRIQUEZ COTA/L
Practice Location Address:

4201 STONEGATE BLVD
FORT WORTH, TX
76109-9503

Practice Phone: 817-924-5440
Practice Fax:

1477033512 — LARRY DON BOARDMAN PTA
Practice Location Address:

4201 STONEGATE BLVD
FORT WORTH, TX
76109-9503

Practice Phone: 817-924-5440
Practice Fax:

Directions to “KELLER ARMY COMMUNITY HOSPITAL ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.