12TH MEDICAL GROUP RANDOLPH is a military/u.s. coast guard outpatient clinic center in Randolph A F B, TX. The provider is the Defense Health Program or U.S. Coast Guard funded fixed facilities or distinct parts of a facility, providing outpatient medical and dental services, primarily for Uniformed Services beneficiaries. A fixed facility is a non-temporary, non-deployed facility. It includes mobile specialty units such as Magnetic Resonance Imaging (MRI) units that may furnish services at the fixed facility. It includes, as examples, the institutional portion of outpatient encounters (except Ambulatory Procedure Visits), supplies issued (e.g., glasses, ostomy supplies, crutches), and radiology and laboratory studies. Does not include items issued directly to a patient from an outpatient pharmacy or patient transport. 12TH MEDICAL GROUP RANDOLPH NPI is 1316911597. The provider is registered as an organization entity type.
The provider Other Name Is Randolph Afb Clinic.
The provider's business location address is:
221 3RD ST W
BLDG 1040
RANDOLPH A F B, TX
ZIP 78150-800
Phone: (210) 652-2420
Fax: (210) 652-6571
The provider's authorized official is Serena Lynn Hansken .
The authorized official title is Air Force Uniform Business Office and has the following contact phone number (703) 588-6419.
The enumeration date for this NPI number is 2/15/2006 and was last updated on 11/15/2010.