377Th Medical Group in Kirtland Afb - Military/u.s. Coast Guard Outpatient
377Th Medical Group - NPI 1912982810
377Th Medical Group is a Military/u.s. Coast Guard Outpatient in Kirtland Afb, New Mexico. 377Th Medical Group practices all healthcare services and medical treatments related to Military/u.s. Coast Guard Outpatient. The NPI Number for 377Th Medical Group is 1912982810. The last update date is 2014-03-10.
377Th Medical Group's current location address is 2050a Second St Se, Kirtland Afb, New Mexico. You can contact this provider via phone number 5058463605 and fax number 5058463594. The mailing address for 377Th Medical Group is 2050a Second St Se, Kirtland Afb, New Mexico. To know further, please read the information below!
Provider Profile Detail
Provider Organization | 377Th Medical Group |
---|---|
Address | 2050a Second St Se, Kirtland Afb, New Mexico |
Phone Number | 5058463605 |
Fax Number | 5058463594 |
Sole Proprietor | -- |
Credentials | -- |
Authorized Official
Title or Position | AIR FORCE |
---|---|
Authorized Official Name | Mitchell Marie Theresa |
Telephone Number | 7036817613 |
NPI Number Detail
NPI Number | 1912982810 |
---|---|
Provider Enumeration Date | 2005-12-13 |
Last Updated Date | 2014-03-10 |
Provider Mailing Address Detail
Address | 2050a Second St Se |
---|---|
City | Kirtland Afb |
State | New Mexico (NM) |
Post Code | 871175524 |
Phone Number | 5058463605 |
Fax Number | 5058463594 |
Provider's Primary Taxonomy Detail
Speciality | Military/u.s. Coast Guard Outpatient |
---|---|
Taxonomy | 261Qm1100X |
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 |
Provider's Other Legacy Identifiers
Identifier | Identifier Type | Identifier State | Identifier Issuer |
---|---|---|---|
32-08926 | NM | NCPDP |
Post Comment/ Review Below
What is the unique 10-digit identification code assigned to 377Th Medical Group by the Centers for Medicare & Medicaid Services?
The 377Th Medical Group has been issued the NPI (National Provider Identifier) 1912982810, which serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Could you please provide the complete physical location address of 377Th Medical Group?
The 377Th Medical Group is physically situated at 2050A Second St Se, in the city of Kirtland Afb, state of NM, with the postal code 871175524.
What is the 377Th Medical Group's specialty and taxonomy code?
The 377Th Medical Group's specialty is Military/u.s. Coast Guard Outpatient, and the corresponding taxonomy code is 261Qm1100X.
On what date did the Centers for Medicare & Medicaid Services issue the 1912982810 to 377Th Medical Group?
The 377Th Medical Group received its 1912982810 assignment from the Centers for Medicare & Medicaid Services on 2005-12-13.
As of what date was the information regarding 377Th Medical Group, such as address, specialty, and other details, last verified and confirmed to be up-to-date?
The information related to 377Th Medical Group, including its address, specialty, and other relevant details, was last verified and confirmed to be up-to-date on 2014-03-10.
NPI Number: 1336142389
Address: Po Box 2004, East Syracuse, NY