Fe Warren Afb

LBN: 90Th Medical Group-United States Air Force
Fe Warren Afb is an health care organization with primary practice located at 6900 Alden Dr Bldg 160 , Fe Warren Afb WY 82005-2945. 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. 90Th Medical Group-United States Air Force can be contacted via phone (307) 773-4855, or through Mitchell, Theresa Marie via phone (703) 681-7613.

Contact Information

Primary practice address
6900 Alden Dr Bldg 160 Fe Warren Afb WY 82005-2945
Phone: (307) 773-4855
Fax: (307) 773-3731
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 1609859826
LBN Legal business name 90Th Medical Group-United States Air Force
DBA Doing business as Fe Warren Afb
Authorized official Mitchell, Theresa Marie
Entity Organization
Organization subpart 1 No
Enumeration date Nov 22nd, 2005
Last updated Feb 27th, 2023 - about last year

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 1609859826 NPPES
Wyoming Other 52-03625 NCPDP

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