341 MEDICAL GROUP (NPI# 1720596810) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720596810 |
| Entity Type | Organization |
| Organization Name | 341 MEDICAL GROUP |
| Practice Address |
7300 N Perimeter Rd Malmstrom Afb MT 59402-6701 |
| Practice Telephone | 4067312110 |
| Mailing Telephone | 4067312110 |
| Enumeration Date | 2018-01-11 |
| Last Update Date | 2018-01-11 |
| Authorized Official Name | CRAIG FORCUM (COMMANDER) |
| Authorized Official Telephone | 4067313863 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM1100X |
Clinic/Center Specialization: Military/U.S. Coast Guard Outpatient |
1100 | NE | Ambulatory Health Care Facilities |
| Street Address |
7300 N PERIMETER RD |
| City | MALMSTROM AFB |
| State | MT |
| Zip Code | 59402-6701 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205837184 | Deborah M Garrity | Pediatrics | 7300 N Perimeter Rd, Malmstrom Afb, MT 59402-6701 | 2005-08-02 |
| 1083220149 | Mayra Y Corona | Dental Assistant | 7300 N Perimeter Rd, Malmstrom Afb, MT 59402-6701 | 2020-09-23 |
| 1962012781 | Mercy Jean Padgett | Dental Hygienist | 7300 N Perimeter Rd, Malmstrom Afb, MT 59402-6701 | 2020-08-06 |
| 1801305180 | Gabriella Seraphina Darrow | Dietitian, Registered | 7300 N Perimeter Rd, Malmstrom Afb, MT 59402-6701 | 2017-09-29 |
| 1134642036 | Nancy M Branch | Nurse Practitioner | 7300 N Perimeter Rd, Malmstrom Afb, MT 59402-6701 | 2017-07-23 |
| 1649623042 | Craig Brown | Dentist | 7300 N Perimeter Rd, Malmstrom Afb, MT 59402-6701 | 2016-07-20 |
| 1407222490 | Rachel Elder | Pharmacist | 7300 N Perimeter Rd, Malmstrom Afb, MT 59402-6701 | 2015-08-13 |
| 1710392352 | 341st Medical Group | Pharmacy | 7300 N Perimeter Rd, Malmstrom Afb, MT 59402-6701 | 2014-06-23 |
| 1265862478 | Michael Rohan | Military Health Care Provider | 7300 N Perimeter Rd, Malmstrom Afb, MT 59402-6701 | 2013-11-25 |
| 1578819728 | Jacquelyn Marie Moore | Pharmacist | 7300 N Perimeter Rd, Malmstrom Afb, MT 59402-6701 | 2012-07-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194255166 | Jonathan Tankersley | Dentist | 7300 Perimeter Rd, Malmstrom Afb, Mt 59402, Dental Clinic, Apo, AA 59402 | 2017-06-13 |
| 1780061960 | Usv Optical Inc | Eyewear Supplier (Equipment, not the service) | 7200 Perimeter Rd., Bldg 1340, Malmstrom Afb, MT 59402 | 2015-04-27 |
| 1396181533 | 341st Medical Group | Military/U.S. Coast Guard Pharmacy | 341 Mdg/mdss/sgsa 7300 N Perimeter Rd, Bldg 2040, Malstrom Afb, MT 59402 | 2013-05-15 |
| 1205098258 | Dennis Gordon Vanhook | Social Worker | 7300 N Peirmeter Road, 341st Medical Group, Malmstrom Afb, MT 59402 | 2008-07-01 |
| 1437205119 | Misty Dawn Robertson | Dental Hygienist | 3700 N Perimeter Road, Malmstrom Afb, MT 59402 | 2007-01-26 |
| 1699738278 | Carol F Nelson | Nurse Practitioner | 7300 North Perimeter Rd, Malmstrom Afb, MT 59402 | 2006-04-06 |
| 1952541716 | Stacey Renee Vierra | Physician Assistant | 7300 North Perimeter Road, 341 Medical Group, Malmstrom Afb, MT 59402 | 2009-03-05 |
| 1306094461 | Jeremy Gustafson | Pharmacist | 7300 North Perimeter Road, Malmstrom Afb, MT 59402 | 2008-09-03 |
| 1356329817 | Timothy Paul Gacioch | Physician Assistant | 4300 Perimeter Rd, (341st Med Group) Bldg 2040, Room S156, Malmstrom Afb, MT 59402-0001 | 2006-01-05 |
| 1104848159 | Malmstrom Air Force Base | Military Hospital | 7300 N Perimeter Rd Bldg 2040, 341 Mdos/sgomhf Malmstrom Afb, Great Falls, MT 59402-6701 | 2006-07-25 |
| Find all providers in zip 59402 | ||||
| Taxonomy Code | 261QM1100X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Military/U.S. Coast Guard Outpatient |
| The Defense Health Program or U.S. Coast Guard funded "fixed" facilities or distinct parts of a facility, providing outpatient medical and dental services, primarily for Uniformed Services beneficiaries. A "fixed" facility is a non-temporary, non-deployed facility. It includes mobile specialty units such as Magnetic Resonance Imaging (MRI) units that may furnish services at the "fixed" facility. It includes, as examples, the institutional portion of outpatient encounters (except Ambulatory Procedure Visits), supplies issued (e.g., glasses, ostomy supplies, crutches), and radiology and laboratory studies. Does not include items issued directly to a patient from an outpatient pharmacy or patient transport. |
| Notes: Source: TRICARE Management Activity Uniform Business Office User’s Guide [1/1/2005: title modified, definition added; 7/1/2006 title modified, definition modified] |
| City | MALMSTROM AFB |
| Zip Code | 59402 |
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| 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.