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Suppliers Military/U.S. Coast Guard Pharmacy

Provider NPI: 1912971441

Organization Information:
Organization Name:  75TH MEDICAL GROUP SGSB
Organization is not Subpart

Practice Location:
7321 11TH ST BLDG 570 HILL AFB, UT 84056-5012 US
Tel: 801-586-9548  Fax: 801-777-6919

Business Mailing Address:
7321 11TH ST BLDG 570 HILL AFB, UT 84056-5012 US
Tel: 801-586-9548  Fax: 801-777-6919

NPI Information:
NPI: 1912971441
Entity Type: Organization


PrimaryCodeCategory/DescriptionStateLicense Number
Military/U.S. Coast Guard Pharmacy
Military Hospital
N261QM1101XAmbulatory Health Care Facilities
Y261QM1100XAmbulatory Health Care Facilities

Other Provider Identifiers:


American Medical Association 2012 taxonomy code information

Code: 261QM1100X





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