Dod Mt Home Ephcy

LBN: 366 Medical Group Sgsbf
Dod Mt Home Ephcy is an health care organization with primary practice located at 90 Hope Dr Bldg 6000 , Mountain Home Afb ID 83648-1062. 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. 366 Medical Group Sgsbf can be contacted via phone (208) 828-7521, or through Morales, Hector via phone (210) 536-6650.

Contact Information

Primary practice address
90 Hope Dr Bldg 6000 Mountain Home Afb ID 83648-1062
Phone: (208) 828-7521
Fax: (208) 828-7676
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 1144636515
LBN Legal business name 366 Medical Group Sgsbf
DBA Doing business as Dod Mt Home Ephcy
Authorized official Morales, Hector
Entity Organization
Organization subpart 1 No
Enumeration date Jul 7th, 2014
Last updated Feb 9th, 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 1144636515 NPPES
Other 2146667 PK

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