Dod Peterson Satl Ephcy

LBN: 21St Medical Group
Dod Peterson Satl Ephcy is an health care organization with primary practice located at 110 W Ent Ave , Peterson Afb CO 80914-1595. The organization recently has 2 registered licenses in different health care specialties including Suppliers / Military/U.S. Coast Guard Pharmacy, Suppliers / Pharmacy. Suppliers / Military/U.S. Coast Guard Pharmacy is the primary health care specialty. 21St Medical Group can be contacted via phone (719) 556-0865, or through Morales, Hector via phone (210) 536-6650.

Contact Information

Primary practice address
110 W Ent Ave Peterson Afb CO 80914-1595
Phone: (719) 556-0865
Fax: (719) 556-1106
Website:
Map and Directions
Authorized official contact:
Name: Morales, Hector
Phone: (210) 536-6650

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Military/U.S. Coast Guard Pharmacy 332000000X
Suppliers / Pharmacy 333600000X

Profile Details

NPI number 1932514171
LBN Legal business name 21St Medical Group
DBA Doing business as Dod Peterson Satl Ephcy
Authorized official Morales, Hector
Entity Organization
Organization subpart 1 No
Enumeration date Jun 26th, 2014
Last updated Apr 5th, 2016 - 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 1932514171 NPPES
Other 2146545 PK

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