Grand Forks Mtf

LBN: 319Th Medical Group
Grand Forks Mtf is an health care organization with primary practice located at 1599 J St , Grand Forks Afb ND 58205-6306. The organization recently has 3 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, Suppliers / Military/U.S. Coast Guard Pharmacy. Ambulatory Health Care Facilities / Military/U.S. Coast Guard Outpatient is the primary health care specialty. 319Th Medical Group can be contacted via phone (701) 747-5376, or through Mitchell, Theresa Marie via phone (703) 681-7613.

Contact Information

Primary practice address
1599 J St Grand Forks Afb ND 58205-6306
Phone: (701) 747-5376
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Mitchell, Theresa Marie
Phone: (703) 681-7613

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
Suppliers / Military/U.S. Coast Guard Pharmacy 332000000X

Profile Details

NPI number 1578523924
LBN Legal business name 319Th Medical Group
DBA Doing business as Grand Forks Mtf
Authorized official Mitchell, Theresa Marie
Entity Organization
Organization subpart 1 No
Enumeration date Mar 27th, 2006
Last updated Feb 18th, 2014 - about 10 years 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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Identifiers

StateTypeNumberIssuer
All States NPI 1578523924 NPPES
North Dakota Other 35-03922 NCPDP

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