Provider Demographics
NPI:1528161916
Name:ACH KELLER-WEST POINT
Entity type:Organization
Organization Name:ACH KELLER-WEST POINT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:UBO MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SHEYNA
Authorized Official - Middle Name:
Authorized Official - Last Name:TERAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:315-774-8832
Mailing Address - Street 1:900 WASHINGTON RD
Mailing Address - Street 2:ATTN: MCUD-RMD-UBO
Mailing Address - City:WEST POINT
Mailing Address - State:NY
Mailing Address - Zip Code:10996-1197
Mailing Address - Country:US
Mailing Address - Phone:845-938-8239
Mailing Address - Fax:
Practice Address - Street 1:900 WASHINGTON RD
Practice Address - Street 2:
Practice Address - City:WEST POINT
Practice Address - State:NY
Practice Address - Zip Code:10996-1197
Practice Address - Country:US
Practice Address - Phone:845-938-0628
Practice Address - Fax:845-938-0627
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ACH KELLER-WEST POINT
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-09-07
Last Update Date:2025-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2865M2000XHospitalsMilitary HospitalMilitary General Acute Care Hospital
No261QM1100XAmbulatory Health Care FacilitiesClinic/CenterMilitary/U.S. Coast Guard Outpatient
No261QM1101XAmbulatory Health Care FacilitiesClinic/CenterMilitary and U.S. Coast Guard Ambulatory Procedure
No332000000XSuppliersMilitary/U.S. Coast Guard Pharmacy
No341800000XTransportation ServicesMilitary/U.S. Coast Guard Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
OTH000Medicare UPIN
VAD000Medicare UPIN
33025FMedicare PIN