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96TH MEDICAL GROUP NPI 1588647770


NPI Information

NPI: 1588647770
Provider Name: 96TH MEDICAL GROUP

Other Name: 96TH MEDICAL SUPPORT SQUADRON OR 96 MDSS SGSR

Classification: Military Hospital - 2865M2000X
Entity Type: Organization

Specialization: Military General Acute Care Hospital

Address:
307 BOATNER RD
SUITE 114
EGLIN AFB, FL
ZIP 32542
Phone: (850) 883-9015
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96TH MEDICAL GROUP is a military general acute care hospital military hospital in Eglin Afb, FL. The provider is a Department of Defense (DoD) health care organization furnishing inpatient care 24 hours per day in fixed facilities, primarily for DoD beneficiaries. Entity is Defense Health Program (DHP) funded. A fixed facility is a non-temporary, non-deployed facility usually used for health care services. It includes mobile specialty units such as Magnetic Resonance Imaging (MRI) units that may furnish services at the fixed facility. It includes those services and institutional costs usually included in a Diagnosis Related Group as well as pass-through items. 96TH MEDICAL GROUP NPI is 1588647770. The provider is registered as an organization entity type.
The provider Other Name Is 96th Medical Support Squadron Or 96 Mdss Sgsr.

The provider's business location address is:

307 BOATNER RD
SUITE 114
EGLIN AFB, FL
ZIP 32542-302
Phone: (850) 883-9015
Fax: (850) 883-8659

The provider's authorized official is Theresa Marie Mitchell .
The authorized official title is Air Force Uniform Business Office and has the following contact phone number (703) 681-7613.

The enumeration date for this NPI number is 11/22/2005 and was last updated on 2/18/2014.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1332000000XMilitary/U.S. Coast Guard PharmacyNo
2261QM1100XClinic/CenterMilitary/U.S. Coast Guard OutpatientNo
3261QM1101XClinic/CenterMilitary and U.S. Coast Guard Ambulatory ProcedureNo
42865M2000XMilitary HospitalMilitary General Acute Care HospitalYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
110-79260OTHERFLORIDANCPDP

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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