National Provider Identifier Database

97TH MEDGRP ALTUS
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.


Contact Information

97TH MEDGRP-ALTUS
301 N 1ST ST
BLDG 46
ALTUS AFB, OK73523-5004
Phone: 580-481-5400
Fax: 580-481-5416
Website:
Specialty Taxonomy Code
* Military/U.S. Coast Guard Outpatient 261QM1100X

* Indicates primary specialty

NPI Profile & details for 97TH MEDGRP-ALTUS

NPI Number 1093782880
Legal business name
LBN
97TH MEDGRP-ALTUS
Authorized official JEN LEWANDOWSKI - (DHA UBO)
Entity Organization
Organization subpart Yes
Enumeration date 03/01/2006
Last updated 06/17/2025 - About 12 months ago
Sole proprietor1 Not specified
Identifiers
  • OK Other: 3720225 NCPDP

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

Reviews for 97TH MEDGRP-ALTUS

There are currently no reviews for 97TH MEDGRP-ALTUS


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