DEPARTMENT OF THE AIR FORCE 72D MEDICAL GROUP


Address: 7050 Air Depot Blvd, Tinker Afb, OK 73145-8716
Phone: 4055826315

DEPARTMENT OF THE AIR FORCE 72D MEDICAL GROUP (NPI# 1568877702) 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) 1568877702
Entity Type Organization
Organization Name DEPARTMENT OF THE AIR FORCE 72D MEDICAL GROUP
Other Organization Name DOD TINKER EPHCY
Practice Address 7050 Air Depot Blvd
Tinker Afb
OK 73145-8716
Mailing Address Department of The Air Force 72d Medical Group
5700 Arnold St
Tinker Afb
OK 73145-8105
Practice Telephone 4055826315
Practice Fax Number 4057362890
Mailing Telephone 4057362890
Mailing Fax Number 4055826315
Enumeration Date 2014-06-26
Last Update Date 2016-01-20
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
Y 332000000X Military/U.S. Coast Guard Pharmacy Suppliers

Other Provider Identifier

State Issuer Identifier Type Code
PK 2146555 01

Other Provider/Organization Names

Other Name Type Code
DoD TINKER ePhcy Doing Business As Name - Organization

Office Location

Street Address 7050 AIR DEPOT BLVD
City TINKER AFB
State OK
Zip Code 73145-8716

Providers in the same location

NPI Name Taxonomy Address Enumeration
1902893084 Michelle Marie Wueste Pediatrics 7050 Air Depot Blvd, Tinker Afb, OK 73145-8716 2005-10-04
1114486701 James Neal Dillard IIi Physician Assistant 7050 Air Depot Blvd, Tinker Afb, OK 73145-8716 2019-03-14
1407313125 Cindy Yie Physician Assistant 7050 Air Depot Blvd, Tinker Afb, OK 73145-8716 2019-02-28
1720501299 William Moore Student in an Organized Health Care Education/Training Program 7050 Air Depot Blvd, Tinker Afb, OK 73145-8716 2017-07-17
1265954952 Mark Gosnell Jr. Military Health Care Provider 7050 Air Depot Blvd, Tinker Afb, OK 73145-8716 2017-07-13
1245780170 Mary Phillips Social Worker 7050 Air Depot Blvd, Tinker Afb, OK 73145-8716 2016-10-04
1528418175 David Rodriguez Family Medicine 7050 Air Depot Blvd, Tinker Afb, OK 73145-8716 2016-06-14
1497120760 Thaddeus Dwayne Mitcham Physician Assistant 7050 Air Depot Blvd, Tinker Afb, OK 73145-8716 2015-12-11
1659755064 Benjamin Winston Dentist 7050 Air Depot Blvd, Sgdd, Tinker Afb, OK 73145-8716 2015-07-15
1063895068 Andrea Theye Psychologist 7050 Air Depot Blvd, Tinker Afb, OK 73145-8716 2015-07-08
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Providers in the same zip code

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
1558748491 Caitlin Clare Stevens General Practice 7050 Air Depot Blvd Bldg 1094, Tinker Afb, OK 73145 2015-04-29
1033498571 Sarah Katherine Turbush Dentist 72d Medical Group, Tinker Afb, OK 73145 2011-08-16
1508000282 Axelandra Tamar Sang Military Health Care Provider 5700 Arnold St, Bldg 5801, Tinker Afb, OK 73145 2009-04-27
1790936466 William David Hinojosa Surgery 7050 Air Depot Blvd Bldg 1094, Tinker Afb, OK 73145 2008-09-30
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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 city

NPI Name Taxonomy Address Enumeration
1245337096 72 Nd Medical Group Military/U.S. Coast Guard Pharmacy 5700 Arnold St Bldg 5801, Tinker Afb, OK 73145-8105 2006-09-20
1801871371 72d Medical Group Military/U.S. Coast Guard Pharmacy 5700 Arnold St., Tinker Afb, OK 73145-8012 2005-12-07

Providers in the same taxonomy and state

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
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Competitor

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City TINKER AFB
Zip Code 73145

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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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