71TH MEDICAL GROUP SGSL


Address: 527 Gott Rd, Enid, OK 73705-5103
Phone: 5802137783

71TH MEDICAL GROUP SGSL (NPI# 1710086079) 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) 1710086079
Entity Type Organization
Organization Name 71TH MEDICAL GROUP SGSL
Other Organization Name VANCE PHCY 71ST MDG
Practice Address 527 Gott Rd
Enid
OK 73705-5103
Practice Telephone 5802137783
Practice Fax Number 5802137995
Mailing Telephone 5802137783
Mailing Fax Number 5802137995
Enumeration Date 2006-09-22
Last Update Date 2016-01-22
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 2076297 01

Other Provider/Organization Names

Other Name Type Code
VANCE PHCY 71ST MDG Doing Business As Name - Organization

Other Provider IDs and Locations

NPI Name Taxonomy Address Enumeration
1508965831 71th Medical Group Sgsl Military/U.S. Coast Guard Pharmacy 4881 Sugar Maple Dr, Bldg 1250, Wright Patter, OH 45433-5529 2006-09-22

Office Location

Street Address 527 GOTT RD
City ENID
State OK
Zip Code 73705-5103

Providers in the same location

NPI Name Taxonomy Address Enumeration
1043200793 David Barnard Family Medicine 527 Gott Rd, Enid, OK 73705-5103 2005-10-25
1184225138 Danielle Young Social Worker 527 Gott Rd, Enid, OK 73705-5103 2020-11-05
1598301277 Anh N Ison Pharmacist 527 Gott Rd, Enid, OK 73705-5103 2019-11-18
1336792340 Liam Connall Noone Military Health Care Provider 527 Gott Rd, Enid, OK 73705-5103 2019-07-18
1225598980 Andrew Jonathan Carey Military Health Care Provider 527 Gott Rd, Enid, OK 73705-5103 2019-03-20
1801306188 Scott Lynn Chance Pharmacist 527 Gott Rd, Enid, OK 73705-5103 2017-10-02
1114458957 Chang Liu Lipinski Family Medicine 527 Gott Rd, Enid, OK 73705-5103 2017-03-23
1417349697 Usaf Military Hospital 527 Gott Rd, Enid, OK 73705-5103 2015-02-25
1962818336 71 Mdg Mdss Sgsr Military/U.S. Coast Guard Pharmacy 527 Gott Rd, Enid, OK 73705-5103 2014-07-07
1689080418 Alison Allen Pediatrics 527 Gott Rd, Enid, OK 73705-5103 2014-07-01
Find all providers in the same location

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1699074013 Christopher Lee Endres Military Health Care Provider 527 Gott Road, Vance Clinic, Vance Afb, OK 73705 2011-03-24
1578128070 Jason Ruggieri Psychologist 527 Gott Road, Bldg 816, Enid, OK 73705-5103 2019-05-09
1831556455 Jennifer Anne Barclay Pediatrics 527 Gott Rd Bldg 810, Enid, OK 73705-5103 2016-01-27
1669991758 Omer S Sanabria Dentist 71st Mdg, 527 Gott Rd., Bldg 810, Enid, OK 73705-5105 2017-09-11
1164661096 Traci Lynn Johnson Licensed Vocational Nurse 71 Mdg, 527 Gott Rd, Vance Afb, OK 73705-5105 2009-02-17
1255395174 Christopher Makoto Tsueda Family Medicine 71 Medical Group, 527 Gott Road, Vance Afb, OK 73705-5105 2006-04-17
1447393889 William F. Blackerby Clinical Neuropsychologist 71 Medical Group, 527 Gott Road Vance Afb, Enid, OK 73705-5105 2007-02-15
1306820915 Ronald Stuart Johnson Psychologist 320 Young Rd, 71 Mdos/sgoml Building 248, Enid, OK 73705-5506 2005-12-06
1851659809 Sunland Optical Co., Inc. Eyewear Supplier (Equipment, not the service) 242 Fields St Bldg 415, Enid, OK 73705-5700 2012-04-27

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
1962818336 71 Mdg Mdss Sgsr Military/U.S. Coast Guard Pharmacy 527 Gott Rd, Enid, OK 73705-5103 2014-07-07
1932187838 71st Medical Group Military/U.S. Coast Guard Pharmacy 527 Gott Rd, Enid, OK 73705-5103 2006-01-03

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
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
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
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
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City ENID
Zip Code 73705

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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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