95Th Medical Group Sgsr

LBN: 95Th Medical Group Sgsr
95Th Medical Group Sgsr is an health care organization with primary practice located at 30 Nightingale Rd Bldg 5525, Edwards Afb CA 93524-0001. 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. 95Th Medical Group Sgsr can be contacted via phone (661) 275-2634, or through Mitchell, Theresa Marie via phone (703) 681-7613.

Contact Information

Primary practice address
30 Nightingale Rd Bldg 5525 Edwards Afb CA 93524-0001
Phone: (661) 275-2634
Fax: (661) 277-6645
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 1891765046
LBN Legal business name 95Th Medical Group Sgsr
DBA Doing business as
Authorized official Mitchell, Theresa Marie
Entity Organization
Organization subpart 1 No
Enumeration date Jan 23rd, 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1891765046 NPPES
California Other 05-40345 NCPDP

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