375Th Medical Group

LBN: 375Th Medical Group
375Th Medical Group is an health care organization with primary practice located at 310 W Losey St , Scott Afb IL 62225-5250. 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, Hospitals / Military Hospital. Ambulatory Health Care Facilities / Military/U.S. Coast Guard Outpatient is the primary health care specialty. 375Th Medical Group can be contacted via phone (618) 256-7392, or through Eaton, Christopher Douglas via phone (703) 681-6303.

Contact Information

Primary practice address
310 W Losey St Scott Afb IL 62225-5250
Phone: (618) 256-7392
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Eaton, Christopher Douglas
Phone: (703) 681-6303

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
Hospitals / Military Hospital 286500000X

Profile Details

NPI number 1851373161
LBN Legal business name 375Th Medical Group
DBA Doing business as
Authorized official Eaton, Christopher Douglas
Entity Organization
Organization subpart 1 No
Enumeration date Nov 14th, 2005
Last updated Aug 16th, 2007 - about 17 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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