72 ND MEDICAL GROUP (NPI# 1245337096) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245337096 |
| Entity Type | Organization |
| Organization Name | 72 ND MEDICAL GROUP |
| Other Organization Name | TINKER PHCY |
| Practice Address |
5700 Arnold St Bldg 5801 Tinker Afb OK 73145-8105 |
| Practice Telephone | 4057362222 |
| Practice Fax Number | 4057367272 |
| Mailing Telephone | 4057362222 |
| Mailing Fax Number | 4057367272 |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2016-01-20 |
| 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 | 2076292 | 01 |
| Other Name | Type Code |
|---|---|
| TINKER PHCY | Doing Business As Name - Organization |
| Street Address |
5700 ARNOLD ST BLDG 5801 |
| City | TINKER AFB |
| State | OK |
| Zip Code | 73145-8105 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417190513 | Yamily Cruz Soto | Military Health Care Provider | 5700 Arnold St Bldg 5801, Tinker Afb, OK 73145-8105 | 2009-04-20 |
| 1497913081 | Jerri Louise Turner | Psychologist | 5700 Arnold St Bldg 5801, Tinker Afb, OK 73145-8105 | 2008-05-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922630946 | The Janz Corporation | Durable Medical Equipment & Medical Supplies | Tinker Afb Exchange, 3360 N. Avenue Bldg. 685, Tinker Afb, OK 73145 | 2020-02-07 |
| 1578863437 | Stephanie Brushett | Audiologist | 8941 Entrance Road A, Bldg 3334, Rm 125, Tinker Afb, OK 73145 | 2010-10-26 |
| 1972530053 | Mark Robert Bacon | Physician Assistant | 72nd Medical Group, 5700 Arnold St, Tinker Afb, OK 73145 | 2006-06-26 |
| 1417945346 | Heather Renee' Ranger Kobel | Psychologist | 590 Mitchell Blvd, Tinker Afb, OK 73145 | 2005-10-13 |
| 1003332404 | Davis Brigman | Psychologist | 7050 Air Depot Blvd Bldg 1094, Tinker Afb, OK 73145 | 2017-08-17 |
| 1801321393 | Carolyne Bangurah | Registered Nurse | 7050 Air Depot Blvd Bldg 1094, Tinker Afb, OK 73145 | 2017-04-21 |
| 1598148850 | Adrianna Harrell | Social Worker | 7050 Air Depot Blvd, Tinker Afb, OK 73145 | 2015-07-06 |
| 1558748491 | Caitlin Clare Stevens | General Practice | 7050 Air Depot Blvd Bldg 1094, Tinker Afb, OK 73145 | 2015-04-29 |
| 1699015032 | Alan Robert Miner | General Practice | 7050 Air Depot Blvd, Oklahoma City, OK 73145 | 2013-02-21 |
| 1033498571 | Sarah Katherine Turbush | Dentist | 72d Medical Group, Tinker Afb, OK 73145 | 2011-08-16 |
| Find all providers in zip 73145 | ||||
| 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 |
|---|---|---|---|---|
| 1801871371 | 72d Medical Group | Military/U.S. Coast Guard Pharmacy | 5700 Arnold St., Tinker Afb, OK 73145-8012 | 2005-12-07 |
| 1568877702 | Department of The Air Force 72d Medical Group | Military/U.S. Coast Guard Pharmacy | 7050 Air Depot Blvd, Tinker Afb, OK 73145-8716 | 2014-06-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457654766 | Reynolds Army Community Hospital | Military/U.S. Coast Guard Pharmacy | Custer Road, Bldg 2913, Fort Sill, OK 73503 | 2010-12-08 |
| 1831298017 | Reynolds Army Community Hospital | Military/U.S. Coast Guard Pharmacy | Macomb Rd Bldg 1719, Ft Sill, OK 73503 | 2006-09-22 |
| 1740389923 | Reynolds Army Community Hospital | Military/U.S. Coast Guard Pharmacy | Thomas Rd Bldg 6043 Tmc2, Ft Sill, OK 73503 | 2006-09-22 |
| 1194824458 | Reynolds Army Community Hospital | Military/U.S. Coast Guard Pharmacy | Reynolds Comm Hosp Dept of Phcy, 4300 Thomas St Bldg 4300, Ft Sill, OK 73503 | 2006-09-22 |
| 1982703245 | Reynolds Army Community Hospital | Military/U.S. Coast Guard Pharmacy | Us Army Health Clinic Aar Mcalester, Ic Tree Road, Mcalester, OK 74301-5000 | 2006-09-22 |
| 1962818336 | 71 Mdg Mdss Sgsr | Military/U.S. Coast Guard Pharmacy | 527 Gott Rd, Enid, OK 73705-5103 | 2014-07-07 |
| 1225442056 | Reynolds Army Community Hospital | Military/U.S. Coast Guard Pharmacy | 4301 Wilson St, Reynolds Army Community Hospital, Fort Sill, OK 73503-4472 | 2014-06-19 |
| 1912200221 | Renolds Army Community Hospital | Military/U.S. Coast Guard Pharmacy | 5404 Sw Lee Blvd, Lawton, OK 73505-9695 | 2010-12-08 |
| 1710086079 | 71th Medical Group Sgsl | Military/U.S. Coast Guard Pharmacy | 527 Gott Rd, Enid, OK 73705-5103 | 2006-09-22 |
| 1093782880 | 97th Medical Group | Military/U.S. Coast Guard Pharmacy | 301 N 1st St, Bldg 46, Altus Afb, OK 73523-5004 | 2006-03-01 |
| Find all providers with the same taxonomy | ||||
| City | TINKER AFB |
| Zip Code | 73145 |
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| 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.