42ND MEDICAL GROUP SGSL


Address: Bldg 810 Gunter Annex, Maxwell Afb, AL 36112
Phone: 3344165455

42ND MEDICAL GROUP SGSL (NPI# 1497854566) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1497854566
Entity Type Organization
Organization Name 42ND MEDICAL GROUP SGSL
Other Organization Name MAXWELL GUNTER PHCY
Practice Address Bldg 810 Gunter Annex
Maxwell Afb
AL 36112
Practice Telephone 3344165455
Practice Fax Number 3349531505
Mailing Telephone 3344165455
Mailing Fax Number 3349531505
Enumeration Date 2006-09-22
Last Update Date 2016-02-09
Authorized Official Name HECTOR MORALES (CHIEF DHA PASS)
Authorized Official Telephone 2105366650
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 333600000X Pharmacy Suppliers
Y 332000000X Military/U.S. Coast Guard Pharmacy Suppliers

Other Provider Identifier

State Issuer Identifier Type Code
PK 1994587 01

Other Provider/Organization Names

Other Name Type Code
MAXWELL GUNTER PHCY Doing Business As Name - Organization

Other Provider IDs and Locations

NPI Name Taxonomy Address Enumeration
1255430302 42nd Medical Group Sgsl Pharmacy 330 S Twining St Bldg 760, Maxwell Afb, AL 36112 2006-09-22

Office Location

Street Address BLDG 810 GUNTER ANNEX
City MAXWELL AFB
State AL
Zip Code 36112

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1841836970 Alison Bees Thompson Social Worker 42nd Medical Group, 300 S. Twining St. Bldg 760, Maxwell Afb, AL 36112 2019-11-25
1881245967 Grant M Golombeski Military Health Care Provider 300 S Twinning Dr., Apo, AA 36112 2019-09-20
1477015196 Jennifer Marie Hudson Counselor Jennifer Hudson, 300 South Twining St Bldg 760, Maxwell Afb, AL 36112 2019-04-02
1255801049 Jose Edwin Aviles Military Health Care Provider Kelly Street, Montgomery, AL 36112 2018-12-05
1306316963 Lydia Price Beringer Speech-Language Pathologist 300 S. Twining Street 42 Nd Medical Group, Maxwell Afb, AL 36112 2018-11-27
1114431301 Dean M Kot Physician Assistant Mxf, Kelly St, Apo, AA 36112 2017-11-27
1417353590 Jamie Ellis Social Worker 300 S. Twining St. Bldg 760, Maxwell Afb, AL 36112 2014-11-17
1629419650 Elias N Hydrick Family Medicine 300 S. Twining St., Bldg 760, Maxwell Afb, 42nd Medical Group, Montgomery, AL 36112 2013-07-06
1639454200 Sharon Lewis Pharmacist 300 Southtwining St, Montgomery, AL 36112 2011-10-14
1104158518 Sylvia Ann Newell Dietitian, Registered 50 W Ash St Bldg 841, Montgomery, AL 36112 2010-02-10
Find all providers in zip 36112

Taxonomy Information

Taxonomy Code 332000000X
Grouping Suppliers
Classification Military/U.S. Coast Guard Pharmacy

Taxonomy Definition

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]

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1346349495 United States Army Aeromedical Center Military/U.S. Coast Guard Pharmacy Dustoff Ave Bldg 301, Ft Rucker, AL 36362-5333 2006-09-22
1982010351 United States Army Aeromedical Center Military/U.S. Coast Guard Pharmacy 301 Andrews Avenue, Fort Rucker, AL 36362-5350 2014-07-07
1487068201 Fox Army Health Center Military/U.S. Coast Guard Pharmacy 4100 Goss Rd Sw, Fox Army Health Center, Huntsville, AL 35809-0001 2014-06-19
1558549121 United States Army Aeromedical Center Military/U.S. Coast Guard Pharmacy 5th Ave, Bldg 4405, Ft. Rucker, AL 36362-5333 2008-02-06
1164521217 Fox Army Health Center Military/U.S. Coast Guard Pharmacy Usa Meddac, Bldg 4100 Goss Rd, Redstone Arsenal, AL 35809-7000 2006-09-22

Competitor

Search similar providers

City MAXWELL AFB
Zip Code 36112

Improve Information

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Dataset Information

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.

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