81ST MEDICAL GROUP SGSL (NPI# 1003915422) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003915422 |
| Entity Type | Organization |
| Organization Name | 81ST MEDICAL GROUP SGSL |
| Other Organization Name | KEESLER SATL PHCY |
| Practice Address |
Service Drive Building 1704a Keesler Afb MS 39534 |
| Mailing Address |
81st Medical Group 301 Fisher St Ste 104 Keesler Afb MS 39534 |
| Practice Telephone | 2283778821 |
| Practice Fax Number | 2283776829 |
| Mailing Telephone | 2283778821 |
| Mailing Fax Number | 2283776829 |
| Enumeration Date | 2006-09-22 |
| Last Update Date | 2015-06-19 |
| Authorized Official Name | HECTOR MORALES (CHIEF DHA PASS) |
| Authorized Official Telephone | 2105366650 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332000000X | Military/U.S. Coast Guard Pharmacy | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PK | 2045936 | 01 |
| Other Name | Type Code |
|---|---|
| KEESLER SATL PHCY | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477652899 | 81st Medical Group Sgsl | Military/U.S. Coast Guard Pharmacy | 301 Fisher St # 104, Keesler Afb, MS 39534-2508 | 2006-09-22 |
| Street Address |
SERVICE DRIVE BUILDING 1704A |
| City | KEESLER AFB |
| State | MS |
| Zip Code | 39534 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316568918 | Hanna Chang | Student in an Organized Health Care Education/Training Program | 81 Msgs/gme (keesler Afb), 301 Fisher St, Rm 5a127, Biloxi, MS 39534 | 2020-05-05 |
| 1720617079 | Briana Polk | Student in an Organized Health Care Education/Training Program | Keesler Air Force Base, 301 Fisher Street, Biloxi, MS 39534 | 2020-04-07 |
| 1437718756 | Marquise Westbrook | Student in an Organized Health Care Education/Training Program | 301 Fisher St, Rm 1g123, Keesler Afb, MS 39534 | 2019-06-11 |
| 1124682729 | Joseph Paul Cervone | Student in an Organized Health Care Education/Training Program | 81 Mdss/gme 301 Fisher St, Rm 1g123, Keesler Afb, MS 39534 | 2019-04-29 |
| 1083120851 | Kaitlin May Gruenberg | Student in an Organized Health Care Education/Training Program | 81 Msgs/gme, 301 Fisher St, Rm 5a127, Keesler Afb, MS 39534 | 2017-12-15 |
| 1760912513 | Michael Zipper | Military Health Care Provider | 301 Fisher St, Rm 5a127, 81msgs/sgcq, Keesler Afb, MS 39534 | 2017-06-14 |
| 1184073181 | 81msgs/sgcq | General Acute Care Hospital | 81msgs/sgcq, 301 Fisher St, Rm 5a127, Keesler Afb, MS 39534 | 2016-06-09 |
| 1174972772 | Usaf 81st Medical Group | Military Hospital | 81msgs/sgcq 301 Fisher St, Rm 5a127, Keesler Afb, MS 39534 | 2016-06-06 |
| 1548644677 | Jim Li | Dentist | 81st Medical Group, Keesler Afb, Apo, AA 39534 | 2015-07-18 |
| 1245610872 | Zachary Austin Masters | Surgery | 301 Fisher Street, Rm 5a127, Keesler Air Force Base, MS 39534 | 2015-06-09 |
| Find all providers in zip 39534 | ||||
| Taxonomy Code | 332000000X |
| Grouping | Suppliers |
| Classification | Military/U.S. Coast Guard Pharmacy |
| 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. |
| Notes: Source: TRICARE Management Activity Uniform Business Office User’s Guide [1/1/2005: new; 7/1/2006: modified title, modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619381415 | Department of Air Force 81st Medical Group | Military/U.S. Coast Guard Pharmacy | 506 Larcher Blvd Ste B, Keesler Afb, MS 39534-2342 | 2014-06-19 |
| 1477652899 | 81st Medical Group Sgsl | Military/U.S. Coast Guard Pharmacy | 301 Fisher St # 104, Keesler Afb, MS 39534-2508 | 2006-09-22 |
| 1710967526 | Keesler Medical Center 81mdss Sgsr | Military/U.S. Coast Guard Pharmacy | 301 Fisher St, Ste 101 Rm 1a132, Keesler Afb, MS 39534-2508 | 2006-01-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972917060 | Naval Hospital Pensacola | Military/U.S. Coast Guard Pharmacy | 367 Fuller Rd Ste A-15, Meridian, MS 39309-5408 | 2014-06-17 |
| 1609975036 | Eisenhower Army Medical Center | Military/U.S. Coast Guard Pharmacy | 1001 Lee Avenue, Bldg 1302, Hattiesburg, MS 39401 | 2006-09-22 |
| 1194824516 | Branch Medical Clinic Gulfport | Military/U.S. Coast Guard Pharmacy | 5502 Marvin Shields Blvd, Gulfport, MS 39501 | 2006-09-22 |
| 1386743706 | 14th Medical Group Sgsl | Military/U.S. Coast Guard Pharmacy | 201 Independence Bldg 1100, Columbus, MS 39710-5300 | 2006-09-22 |
| 1558760504 | 14th Medical Squadron | Military/U.S. Coast Guard Pharmacy | 201 Independence Bldg 1100, Columbus, MS 39710-5300 | 2014-08-15 |
| 1558773192 | Branch Medical Clinic Gulfport | Military/U.S. Coast Guard Pharmacy | 5502 Marvin Shields Blvd, Gulfport, MS 39501 | 2014-06-02 |
| 1487630356 | 14th Medical Group | Military/U.S. Coast Guard Pharmacy | 201 Independence, Suite 101, Columbus, MS 39710-5300 | 2005-12-21 |
| City | KEESLER AFB |
| Zip Code | 39534 |
Please comment or provide details below to improve the information on 81ST MEDICAL GROUP SGSL.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.