Guadalupe Free Clinic · Clinic Pharmacy

700 Mckinney Blvd Ste 1100, Colonial Beach, VA 22443-1934

Overview

Guadalupe Free Clinic is a Clinic Pharmacy (organization) practicing in Colonial Beach, Virginia. The National Provider Identifier (NPI) is #1417778275, which was assigned on October 23, 2024, and the registration record was last updated on October 23, 2024. The practitioner's main practice location is at 700 Mckinney Blvd Ste 1100, Colonial Beach, VA 22443-1934; the contact telephone number is 8042240571, and the fax number is 8042240572. The primary taxonomy of Guadalupe Free Clinic is Clinic Pharmacy (3336C0002X), with specialization in Clinic Pharmacy. The authorized official for Guadalupe Free Clinic is Dr. Daniel Muldoon (Medical Director).

A pharmacy in a clinic, emergency room or hospital (outpatient) that dispenses medications to patients for self-administration under the supervision of a pharmacist.

Provider Information

NPI 1417778275
Entity Type Organization
Organization Name GUADALUPE FREE CLINIC
Provider Name GUADALUPE FREE CLINIC
Practice Address 700 Mckinney Blvd Ste 1100
Colonial Beach
VA 22443-1934
Practice Telephone 8042240571
Practice Fax Number 8042240572
Mailing Address 700 Mckinney Blvd Ste 1100
Colonial Beach
VA 22443-1934
Mailing Telephone 8042240571
Mailing Fax Number 8042240572
Certification Date 2024-10-20
Enumeration Date 2024-10-23
Last Update Date 2024-10-23
Is Organization Subpart N

Authorized Official Information

Official Name DR. DANIEL MULDOON
Official Title MEDICAL DIRECTOR
Credential MD
Telephone 5408409002

Taxonomy and Licenses

PrimaryCodeClassificationSpecializationTaxonomy GroupLicense NumberLicense State
Y3336C0002XPharmacyClinic Pharmacy

Other Provider Identifiers

Other IdentifierIssuing StateIssuerIdentifier Type
0201004142VAVIRGINIA DEPARTMENT OF HEALTH PROFESSIONS, BOARD OF PHARMACYOther
C65VAVIRGINIA IMMUNIZATION INFORMATION SYSTEMOther

Taxonomy Information

Primary Taxonomy

Code 3336C0002X
Taxonomy Clinic Pharmacy
Classification Pharmacy
Specialization Clinic Pharmacy
Grouping Suppliers
Definition: A pharmacy in a clinic, emergency room or hospital (outpatient) that dispenses medications to patients for self-administration under the supervision of a pharmacist.
Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new]

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Location Information

Street Address 700 MCKINNEY BLVD STE 1100
City COLONIAL BEACH
State VA
Zip Code 22443-1934
Country US

Providers in the same zip code

Provider NameAddressTaxonomyEnumeration Date
Rodestar L.L.C 1274 Macedonia Ln, Colonial Beach, VA 22443-5815Driver2025-06-16

Providers in the state of VA

Provider NameAddressTaxonomyEnumeration Date
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Dataset Information

This dataset includes over five million health care providers who are assigned National Provider Identifier (NPI) in the National Plan and Provider Enumeration System (NPPES), developed by the Centers for Medicare & Medicaid Services (CMS). Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under Health Insurance Portability and Accountability Act (HIPAA). Each provider is registered with the NPI, full name, status, address, taxonomy, other identifiers, etc.

Subject Transparency and Disclosure
Jurisdiction Federal
Data Provider National Plan and Provider Enumeration System (NPPES), by the Centers for Medicare & Medicaid Services (CMS)
Source download.cms.gov

Dataset Details

The National Provider Identifier (NPI) is a Health Insurance Portability and Accountability Act (HIPAA) Administrative Simplification Standard. The NPI is a unique identification number for covered health care providers and all health plans and health care clearinghouses, who must use the NPIs in the administrative and financial transactions adopted under HIPAA. The NPI is a 10-position, intelligence-free numeric identifier (10-digit number).

All health care providers who are HIPAA-covered entities, whether individuals or organizations, must get an NPI. A HIPAA-covered entity is a health care provider that conducts certain transactions in electronic form, or a health care clearinghouse, or a health plan (including commercial plans, Medicare, and Medicaid).

Centers for Medicare & Medicaid Services (CMS) has developed the National Plan and Provider Enumeration System (NPPES) to assign unique identifiers to health care providers. The National Provider Indentifier (NPI) has been the standard identifier for all HIPAA-covered entities (health care providers) since May 23, 2007. Small health plans were required to obtain and use an NPI by May 23, 2008.

This dataset includes over five million health care providers (individuals and organizations) who are assigned NPI. The provider data elements are disclosed to the public by the Centers for Medicare & Medicaid Services (CMS) under the Freedom of Information Act (FOIA), as listed in the NPPES Data Dissemination Notice (CMS-6060-N). The NPI final rules define the following elements which required to be disclosed as determined by Department of Health & Human Services (HHS): NPI, Entity Type, Provider Name, Credential, Business Mailing Address, Business Location Address, Healthcare Provider Taxonomy Code, Other Provider Identifier, Provider Enumeration Date, NPI Deactivation Date, Provider License Number, Authorized Official Name and Contact Information.