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23RD MEDICAL GROUP NPI 1417362211


NPI Information

NPI: 1417362211
Provider Name: 23RD MEDICAL GROUP

Doing Business As: DOD MOODY EPHCY

Classification: Military/U.S. Coast Guard Pharmacy - 332000000X
Entity Type: Organization
Address:
3278 MITCHELL BLVD
MOODY AFB, GA
ZIP 31699
Phone: (229) 257-3221
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23RD MEDICAL GROUP is a military us coast guard pharmacy in Moody Afb, GA. 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. 23RD MEDICAL GROUP NPI is 1417362211. The provider is registered as an organization entity type.
The provider Is Doing Business As Dod Moody Ephcy.

The provider's business location address is:

3278 MITCHELL BLVD
MOODY AFB, GA
ZIP 31699-500
Phone: (229) 257-3221
Fax: (229) 257-2345

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 7/1/2014 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
12146570OTHERPK

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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