Fairchild Afb Mtf

LBN: 92Nd Medical Group
Fairchild Afb Mtf is an health care organization with primary practice located at 701 Hospital Loop , Fairchild Afb WA 99011-8704. 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. 92Nd Medical Group can be contacted via phone (509) 247-9264, or through Mitchell, Theresa Marie via phone (703) 681-7613.

Contact Information

Primary practice address
701 Hospital Loop Fairchild Afb WA 99011-8704
Phone: (509) 247-9264
Fax: (509) 247-3535
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 1104888288
LBN Legal business name 92Nd Medical Group
DBA Doing business as Fairchild Afb Mtf
Authorized official Mitchell, Theresa Marie
Entity Organization
Organization subpart 1 No
Enumeration date Apr 4th, 2006
Last updated Mar 10th, 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.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1104888288 NPPES
Washington Other 49-24507 NCPDP

Popular Providers