1588040224 NPI number — 48TH MEDICAL GROUP, RAFL, USAF

Table of content: (NPI 1588040224)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1588040224 NPI number — 48TH MEDICAL GROUP, RAFL, USAF

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
48TH MEDICAL GROUP, RAFL, USAF
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1588040224
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/05/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
CHESTER STREET, LAKENHEATH
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BRANDON
Provider Business Mailing Address State Name:
UNITED KINGDOM
Provider Business Mailing Address Postal Code:
IPS7 9PS
Provider Business Mailing Address Country Code:
GB
Provider Business Mailing Address Telephone Number:
163-852-8659
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
CHESTER STREET, LAKENHEATH
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BRANDON
Provider Business Practice Location Address State Name:
UNITED KINGDOM
Provider Business Practice Location Address Postal Code:
IPS7 9PS
Provider Business Practice Location Address Country Code:
GB
Provider Business Practice Location Address Telephone Number:
163-852-8659
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/05/2015

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
SMITH
Authorized Official First Name:
PAMELA
Authorized Official Middle Name:
Authorized Official Title or Position:
HOSPITAL COMMANDER
Authorized Official Telephone Number:
163-852-8001

Provider Taxonomy Codes

  • Taxonomy code: 291900000X , with the licence number:  12487 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 286500000X , with the licence number: 12487 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)