779Th Medical Group

LBN: 316Th Medical Group - Malcolm Grow Medical Center
779Th Medical Group is an health care organization with primary practice located at 1060 W Perimeter Rd , Jb Andrews MD 20762-6602. The organization recently has 2 registered licenses in different health care specialties including Ambulatory Health Care Facilities / Military/U.S. Coast Guard Outpatient, Ambulatory Health Care Facilities / Military and U.S. Coast Guard Ambulatory Procedure. Ambulatory Health Care Facilities / Military and U.S. Coast Guard Ambulatory Procedure is the primary health care specialty. 316Th Medical Group - Malcolm Grow Medical Center can be contacted via phone (240) 857-8658, or through Condon, William Michael via phone (240) 401-3643.

Contact Information

Primary practice address
1060 W Perimeter Rd Jb Andrews MD 20762-6602
Phone: (240) 857-8658
Fax: (240) 857-7700
Website:
Map and Directions
Authorized official contact:
Name: Condon, William Michael
Phone: (240) 401-3643

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Military/U.S. Coast Guard Outpatient 261QM1100X
Ambulatory Health Care Facilities / Military and U.S. Coast Guard Ambulatory Procedure 261QM1101X

Profile Details

NPI number 1215994660
LBN Legal business name 316Th Medical Group - Malcolm Grow Medical Center
DBA Doing business as 779Th Medical Group
Authorized official Condon, William Michael
Entity Organization
Organization subpart 1 No
Enumeration date Apr 28th, 2006
Last updated Apr 10th, 2024 - about 7 months ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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