325TH MEDICAL GROUP SGSL (NPI# 1285733907) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1285733907 |
| Entity Type | Organization |
| Organization Name | 325TH MEDICAL GROUP SGSL |
| Other Organization Name | TYNDALL SATL PHCY |
| Practice Address |
Magnolia Circle Tyndall Afb FL 32403 |
| Practice Telephone | 8502837557 |
| Practice Fax Number | 8502837061 |
| Mailing Telephone | 8502837557 |
| Mailing Fax Number | 8502837061 |
| Enumeration Date | 2006-09-21 |
| Last Update Date | 2016-09-26 |
| 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 | 2013856 | 01 |
| Other Name | Type Code |
|---|---|
| TYNDALL SATL PHCY | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386708030 | 325th Medical Group Sgsl | Military/U.S. Coast Guard Pharmacy | 340 Magnolia Cir, Tyndall Afb, FL 32403-5604 | 2006-12-20 |
| Street Address |
MAGNOLIA CIRCLE |
| City | TYNDALL AFB |
| State | FL |
| Zip Code | 32403 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326408063 | Nathaniel Criddle | Dentist | 325 Aerospace Medicine Sq/sgpd, 340 Magnolia Circle Bldg 1465, Tyndall Afb, FL 32403 | 2016-02-23 |
| 1952730491 | Erick Laron Jackson | Physical Therapist | 325 Mdg/physical Therapy, 340 Magnolia Circle, Tyndall Afb, FL 32403 | 2013-11-05 |
| 1972830701 | Quan Tram | Pharmacist | 340 Magnolia Cirlcle, Tyndall Afb, FL 32403 | 2009-11-16 |
| 1952473308 | Robert Allen Frick | Family Medicine | 325th Medical Group 340 Magnolia Circle, Tyndall Afb, Panama City, FL 32403 | 2006-11-14 |
| 1093737272 | Walter Edward Calvo | Social Worker | Bldg 1305 Suwannee Ave, Tyndall Afb, FL 32403 | 2006-07-24 |
| 1790727865 | Michelle Gautreaux | Nutritionist | 325 Mdg, 340 Magnolia Circle, Tyndall Afb, FL 32403 | 2006-06-12 |
| 1568436962 | 325 Mdg | Psychologist | 325 Mdg Bldg, 1305 Suwannee Ave, Tyndall Afb, FL 32403 | 2006-02-14 |
| 1780658005 | Brant Casford | Radiology | 325 Mdg/sgsar Radiology, Tyndall Afb, FL 32403 | 2006-02-14 |
| 1215911573 | Rama Bhyravabhotla | Physician Assistant | 325 Mdos/sgomf, 340 Magnolia Circle, Tyndall Afb, FL 32403 | 2005-12-01 |
| 1659355816 | Tracy Lynn Hunter | Specialist | Bldg 1404 Mississippi Rd, Panama City, FL 32403 | 2005-12-01 |
| Find all providers in zip 32403 | ||||
| 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 |
|---|---|---|---|---|
| 1962801928 | 325th Medical Group | Military/U.S. Coast Guard Pharmacy | 340 Magnolia Cir, Tyndall Afb, FL 32403-5604 | 2014-08-15 |
| 1386708030 | 325th Medical Group Sgsl | Military/U.S. Coast Guard Pharmacy | 340 Magnolia Cir, Tyndall Afb, FL 32403-5604 | 2006-12-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114425113 | Naval Hospital Pensacola | Military/U.S. Coast Guard Pharmacy | 2500 Veterans Way, Bldg 645, Panama City, FL 32408 | 2018-01-25 |
| 1134518798 | 96th Medical Support Squadron | Military/U.S. Coast Guard Pharmacy | 3120 A. Talon Way, Eglin Afb Fld #3, FL 32542 | 2015-01-20 |
| 1457764078 | Naval Hospital Pensacola | Military/U.S. Coast Guard Pharmacy | 5820 W Highway 98, Pensacola, FL 32507-1072 | 2014-06-11 |
| 1437562626 | Naval Hospital Pensacola | Military/U.S. Coast Guard Pharmacy | 7119 Langley St Bldg 2985, Milton, FL 32570-6105 | 2014-06-05 |
| 1932512498 | Mayport Refill Pharmacy | Military/U.S. Coast Guard Pharmacy | Naval Health Clinic Mayport, 2104 Massey Ave, Mayport, FL 32228 | 2014-06-03 |
| 1770995300 | Jacksonville Refill Pharmacy | Military/U.S. Coast Guard Pharmacy | Navy Exchange Pharmacy, Bldg 950, Jacksonville, FL 32214-5000 | 2014-06-02 |
| 1598177123 | 96th Medical Support Squadron | Military/U.S. Coast Guard Pharmacy | 96 Medical Group Satellite Phcy Memorial Trail, Bldg. 1758, Eglin Afb, FL 32542 | 2014-06-02 |
| 1518301696 | Naval Hospital Pensacola | Military/U.S. Coast Guard Pharmacy | 5820 West Highway 98, Bldg 3737, Pensacola, FL 32507 | 2013-04-19 |
| 1356653844 | Us Coast Guard Finance Center | Military/U.S. Coast Guard Pharmacy | 100 Trumbo Point Road, Key West, FL 33040 | 2010-07-13 |
| 1518051093 | Hrs Citrus County Health Dept. Pharmacy | Military/U.S. Coast Guard Pharmacy | 2804 Marc Knighton Ct, Lecanto, FL 34461 | 2006-10-02 |
| Find all providers with the same taxonomy | ||||
| City | TYNDALL AFB |
| Zip Code | 32403 |
Please comment or provide details below to improve the information on 325TH 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.