96Th Medical Support Squadron Or 96 Mdss Sgsr

LBN: 96Th Medical Group
96Th Medical Support Squadron Or 96 Mdss Sgsr is an health care organization with primary practice located at 307 Boatner Rd Suite 114, Eglin Afb FL 32542-1302. The organization recently has 4 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, Hospitals / Military General Acute Care Hospital, Suppliers / Military/U.S. Coast Guard Pharmacy. Hospitals / Military General Acute Care Hospital is the primary health care specialty. 96Th Medical Group can be contacted via phone (850) 883-9015, or through Mitchell, Theresa Marie via phone (703) 681-7613.

Contact Information

Primary practice address
307 Boatner Rd Suite 114 Eglin Afb FL 32542-1302
Phone: (850) 883-9015
Fax: (850) 883-8659
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
Hospitals / Military General Acute Care Hospital 2865M2000X
Suppliers / Military/U.S. Coast Guard Pharmacy 332000000X

Profile Details

NPI number 1588647770
LBN Legal business name 96Th Medical Group
DBA Doing business as 96Th Medical Support Squadron Or 96 Mdss Sgsr
Authorized official Mitchell, Theresa Marie
Entity Organization
Organization subpart 1 No
Enumeration date Nov 22nd, 2005
Last updated Feb 18th, 2014 - about 12 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 1588647770 NPPES
Florida Other 10-79260 NCPDP

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