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56TH MEDICAL GROUP

Military Coast Guard Pharmacy

Luke Afb, Arizona

Provider NPI: 1043627631

Organization Information:
Organization Name:  56TH MEDICAL GROUP


Practice Location:
7219 N LITCHFIELD RD BLDG 1130  LUKE AFB, AZ 85309 US
Tel: 623-856-3934  Fax: --

Business Mailing Address:
  ,   
Tel: --  Fax: --


Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
Y332000000XSuppliers
Military/U.S. Coast Guard Pharmacy

Other Provider Identifiers:

IssuerNumberStateType
PK214687901
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin




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