14TH MEDICAL GROUP SGSL (NPI# 1386743706) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1386743706 |
Entity Type | Organization |
Organization Name | 14TH MEDICAL GROUP SGSL |
Other Organization Name | COLUMBUS PHCY |
Practice Address |
201 Independence Bldg 1100 Columbus MS 39710-5300 |
Practice Telephone | 6624342168 |
Practice Fax Number | 6624342169 |
Mailing Telephone | 6624342168 |
Mailing Fax Number | 6624342169 |
Enumeration Date | 2006-09-22 |
Last Update Date | 2016-02-10 |
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 | 2045930 | 01 |
Other Name | Type Code |
---|---|
COLUMBUS PHCY | Doing Business As Name - Organization |
Street Address |
201 INDEPENDENCE BLDG 1100 |
City | COLUMBUS |
State | MS |
Zip Code | 39710-5300 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1558760504 | 14th Medical Squadron | Military/U.S. Coast Guard Pharmacy | 201 Independence Bldg 1100, Columbus, MS 39710-5300 | 2014-08-15 |
1073924395 | Pattie Loftis | Registered Nurse | 201 Independence Bldg 1100, Columbus, MS 39710-5300 | 2014-05-09 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1558653063 | Steven Thomas Fosmire | Preventive Medicine | 14th Medical Group, 201 Independence Dr., Ste 2255, Columbus Afb, MS 39710 | 2011-05-03 |
1457311573 | Benjamin Jordan Franklin | Optometrist | 14 Medical Group, 201 Independence Dr Ste 235, Columbus Afb, MS 39710 | 2006-03-24 |
1396713194 | Kirk Tracy Moss | Family Medicine | 14th Mdg, 201 Independence Dr, Columbus Afb, MS 39710 | 2006-03-09 |
1659367266 | Paul H Nelson | Family Medicine | 201 Independence Dr, 14th Medical Group Ste 235, Columbus Afb, MS 39710 | 2005-09-20 |
1467447201 | James Henry Heriot | Internal Medicine | 201 Independence Drive, 14th Medical Group/sgoq, Columbus Afb, MS 39710 | 2005-09-19 |
1699372938 | Stacie Lynn Penkova | Pharmacist | 14th Medical Group, 201 Independence Drive, Columbus Afb, MS 39710 | 2020-10-08 |
1932696713 | James Tyler Bates | Family Medicine | 201 Independence, Columbus, MS 39710 | 2018-04-17 |
1972964591 | Lauren Beers | Physical Therapist | 201 Independence, Columbus, MS 39710 | 2016-03-09 |
1558740019 | William Jennings Amador | Family Medicine | 201 Independence Drive, 14th Medical Group, Columbus Afb, MS 39710 | 2015-05-29 |
1992117378 | Jennifer Bryant Williams | Social Worker | 201 Independence, Columbus, MS 39710 | 2014-05-20 |
Find all providers in zip 39710 |
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 |
---|---|---|---|---|
1023378403 | Martin Army Community Hospital | Military/U.S. Coast Guard Pharmacy | 1100 Brookstone Centre Pkwy Rm 128, Columbus, GA 31904-4577 | 2012-05-21 |
1558760504 | 14th Medical Squadron | Military/U.S. Coast Guard Pharmacy | 201 Independence Bldg 1100, Columbus, MS 39710-5300 | 2014-08-15 |
1487630356 | 14th Medical Group | Military/U.S. Coast Guard Pharmacy | 201 Independence, Suite 101, Columbus, MS 39710-5300 | 2005-12-21 |
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 |
1972917060 | Naval Hospital Pensacola | Military/U.S. Coast Guard Pharmacy | 367 Fuller Rd Ste A-15, Meridian, MS 39309-5408 | 2014-06-17 |
1003915422 | 81st Medical Group Sgsl | Military/U.S. Coast Guard Pharmacy | Service Drive, Building 1704a, Keesler Afb, MS 39534 | 2006-09-22 |
1609975036 | Eisenhower Army Medical Center | Military/U.S. Coast Guard Pharmacy | 1001 Lee Avenue, Bldg 1302, Hattiesburg, MS 39401 | 2006-09-22 |
1477652899 | 81st Medical Group Sgsl | Military/U.S. Coast Guard Pharmacy | 301 Fisher St # 104, Keesler Afb, MS 39534-2508 | 2006-09-22 |
1194824516 | Branch Medical Clinic Gulfport | Military/U.S. Coast Guard Pharmacy | 5502 Marvin Shields Blvd, Gulfport, MS 39501 | 2006-09-22 |
1558773192 | Branch Medical Clinic Gulfport | Military/U.S. Coast Guard Pharmacy | 5502 Marvin Shields Blvd, Gulfport, MS 39501 | 2014-06-02 |
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 |
Please comment or provide details below to improve the information on 14TH 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.