377Th Medical Group - Kirtland Afb

LBN: 377Th Medical Group - Kirtland Afb
377Th Medical Group - Kirtland Afb is an health care organization with primary practice located at 2050A Second St Se , Kirtland Afb NM 87117-5524. The organization recently has only one registered license in Ambulatory Health Care Facilities / Military/U.S. Coast Guard Outpatient, which is considered as the primary health care specialty. 377Th Medical Group - Kirtland Afb can be contacted via phone (505) 846-3605, or through Mitchell, Theresa Marie via phone (703) 681-7613.

Contact Information

Primary practice address
2050A Second St Se Kirtland Afb NM 87117-5524
Phone: (505) 846-3605
Fax: (505) 846-3594
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

Profile Details

NPI number 1912982810
LBN Legal business name 377Th Medical Group - Kirtland Afb
DBA Doing business as
Authorized official Mitchell, Theresa Marie
Entity Organization
Organization subpart 1 No
Enumeration date Dec 13th, 2005
Last updated Apr 1st, 2024 - about 2 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 1912982810 NPPES
New Mexico Other 32-08926 NCPDP

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