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55TH MEDICAL GROUP SGSL NPI 1194824524


NPI Information

NPI: 1194824524
Provider Name: 55TH MEDICAL GROUP SGSL

Doing Business As: OFFUTT MAIN PHCY

Classification: Military/U.S. Coast Guard Pharmacy - 332000000X
Entity Type: Organization
Address:
2501 CAPEHART RD
BELLEVUE, NE
ZIP 68123
Phone: (402) 294-7358
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55TH MEDICAL GROUP SGSL is a military us coast guard pharmacy in Bellevue, NE. The provider is a Department of Defense (DoD) or U.S. Coast Guard entity whose primary function is to store, prepare and dispense pharmaceuticals and other associated items to Uniformed Services beneficiaries. These pharmacies may be associated with a DoD or U.S. Coast Guard clinic, DoD Hospital or freestanding. Usually associated with outpatient services. 55TH MEDICAL GROUP SGSL NPI is 1194824524. The provider is registered as an organization entity type.
The provider Is Doing Business As Offutt Main Phcy.

The provider's business location address is:

2501 CAPEHART RD
BELLEVUE, NE
ZIP 68123
Phone: (402) 294-7358
Fax: (402) 232-4165

The provider's authorized official is Hector Morales .
The authorized official title is Chief Dha Pass and has the following contact phone number (210) 536-6650.

The enumeration date for this NPI number is 9/22/2006 and was last updated on 2/8/2016.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1333600000XPharmacyNo
2332000000XMilitary/U.S. Coast Guard PharmacyYes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
12055512OTHERPK

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: 4/28/2024

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