National Provider Identifier Database

TRICARE MEDICAL CLINIC SUFFOLK
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

TRICARE MEDICAL CLINIC SUFFOLK
1317 BALLAHACK RD
CHESAPEAKE, VA23322-2499
Phone: 703-681-9522
Fax:
Website:
Specialty Taxonomy Code
* Military/U.S. Coast Guard Outpatient 261QM1100X

* Indicates primary specialty

NPI Profile & details for TRICARE MEDICAL CLINIC SUFFOLK

NPI Number 1821501719
Legal business name
LBN
TRICARE MEDICAL CLINIC SUFFOLK
Authorized official WILLIAM CONDON - (BUMED UBO)
Entity Organization
Organization subpart Yes
Enumeration date 11/14/2017
Last updated 11/14/2017 - About 9 years ago
Sole proprietor1 Not specified
Identifiers n/a

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.

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