366 Medical Group in Mountain Home Afb - Military/u.s. Coast Guard Outpatient
366 Medical Group - NPI 1063487791
366 Medical Group is a Military/u.s. Coast Guard Outpatient in Mountain Home Afb, Idaho. 366 Medical Group practices all healthcare services and medical treatments related to Military/u.s. Coast Guard Outpatient. The NPI Number for 366 Medical Group is 1063487791. The last update date is 2017-11-08.
366 Medical Group's current location address is 90 Hope Drive Bldg 6000, Mountain Home Afb, Idaho. You can contact this provider via phone number 2088287470 and fax number 2088282753. The mailing address for 366 Medical Group is 90 Hope Drive Bldg 6000, Mountain Home Afb, Idaho. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | 366 Medical Group |
|---|---|
| Address | 90 Hope Drive Bldg 6000, Mountain Home Afb, Idaho |
| Phone Number | 2088287470 |
| Fax Number | 2088282753 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | COMMANDER |
|---|---|
| Authorized Official Name | Ward R Steven |
| Credentials | M.D. |
| Telephone Number | 2088287600 |
NPI Number Detail
| NPI Number | 1063487791 |
|---|---|
| Provider Enumeration Date | 2006-02-17 |
| Last Updated Date | 2017-11-08 |
Provider Mailing Address Detail
| Address | 90 Hope Drive Bldg 6000 |
|---|---|
| City | Mountain Home Afb |
| State | Idaho (ID) |
| Post Code | 836481062 |
| Phone Number | 2088287470 |
| Fax Number | 2088282753 |
Provider's Primary Taxonomy Detail
| Speciality | Military/u.s. Coast Guard Outpatient |
|---|---|
| Taxonomy | 261Qm1100X |
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Definition: 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-dep |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 1306845 | ID | NCPDP | |
| 8072078 | ID | -- |
Post Comment/ Review Below
What is the unique 10-digit identifier code assigned to 366 Medical Group by the Centers for Medicare & Medicaid Services?
The 366 Medical Group has been issued the NPI (National Provider Identifier) 1063487791 by the CMS (Centers for Medicare & Medicaid Services), which serves as a unique identification number for healthcare providers.
Could you provide the complete physical address where 366 Medical Group is located?
The 366 Medical Group is situated at the following address: 90 Hope Drive Bldg 6000, Mountain Home Afb, ID, 836481062.
What is the area of specialization for 366 Medical Group, and what is the corresponding taxonomy classification code for this field?
The specialized field of practice for 366 Medical Group is Military/u.s. Coast Guard Outpatient, and the corresponding taxonomy code that categorizes this area of expertise is 261Qm1100X.
When did the 366 Medical Group receive its 1063487791?
The 366 Medical Group was issued its 1063487791 on 2006-02-17, which is the date when the organization was assigned this unique identifier.
When was the information regarding 366 Medical Group most recently updated?
The details pertaining to the 366 Medical Group, including its address, specialty, and other relevant information, were last refreshed on 2017-11-08.