97Th Medical Group
LBN: 97Th Medical Group
97Th Medical Group is an health care organization with primary practice located at 301 N 1St St Bldg 46, Altus Afb OK 73523-5004. 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.
97Th Medical Group can be contacted via phone (580) 481-5400, or through Hansken, Serena Lynn via phone (703) 588-6419.
Contact Information
Primary practice address
301 N 1St St Bldg 46
Altus Afb OK 73523-5004
Phone: (580) 481-5400
Fax: (580) 481-5416
Website:
Health care specialties
| Specialty | Code | License # | 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 | 1093782880 |
|---|---|
| LBN Legal business name | 97Th Medical Group |
| DBA Doing business as | |
| Authorized official | Hansken, Serena Lynn |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Mar 1st, 2006 |
| Last updated | Nov 15th, 2010 - about 14 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1093782880 | NPPES |
| Oklahoma | Other | 3720225 | NCPDP |
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