341ST MEDICAL GROUP (NPI# 1710392352) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1710392352 |
Entity Type | Organization |
Organization Name | 341ST MEDICAL GROUP |
Other Organization Name | DOD MALMSTROM EPHCY |
Practice Address |
7300 N Perimeter Rd Malmstrom Afb MT 59402-6701 |
Mailing Address |
341st Medical Group-united States Air Force 7300 North Perimeter Road Malmstrom Afb MT 59402 |
Practice Telephone | 4067313095 |
Practice Fax Number | 4067314928 |
Mailing Telephone | 4067313095 |
Mailing Fax Number | 4067314928 |
Enumeration Date | 2014-06-23 |
Last Update Date | 2016-02-09 |
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 |
---|---|---|---|---|---|
N | 333600000X | Pharmacy | Suppliers | ||
Y | 332000000X | Military/U.S. Coast Guard Pharmacy | Suppliers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
PK | 2146422 | 01 |
Other Name | Type Code |
---|---|
DOD MALMSTROM ePhcy | Doing Business As Name - Organization |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
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 |
1619074465 | 341st Medical Group | Military/U.S. Coast Guard Pharmacy | 7300 N Perimeter Rd, Malmstrom Afb, MT 59402-6701 | 2006-09-20 |
1285691329 | 341st Medical Group | Military/U.S. Coast Guard Pharmacy | 7300 N Perimeter Rd, Malmstrom Afb, MT 59402-6701 | 2006-05-01 |
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 |
1720596810 | 341 Medical Group | Clinic/Center | 7300 N Perimeter Rd, Malmstrom Afb, MT 59402-6701 | 2018-01-11 |
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 |
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 | 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 |
---|---|---|---|---|
1619074465 | 341st Medical Group | Military/U.S. Coast Guard Pharmacy | 7300 N Perimeter Rd, Malmstrom Afb, MT 59402-6701 | 2006-09-20 |
1285691329 | 341st Medical Group | Military/U.S. Coast Guard Pharmacy | 7300 N Perimeter Rd, Malmstrom Afb, MT 59402-6701 | 2006-05-01 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
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 |
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.