National Provider Identifier Database

377TH MEDGRP KIRTLAND
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

377TH MEDGRP-KIRTLAND
2050A SECOND ST SE
KIRTLAND AFB, NM87117-5524
Phone: 505-846-3605
Fax: 505-846-3594
Website:
Specialty Taxonomy Code
* Military/U.S. Coast Guard Outpatient 261QM1100X

* Indicates primary specialty

NPI Profile & details for 377TH MEDGRP-KIRTLAND

NPI Number 1912982810
Legal business name
LBN
377TH MEDGRP-KIRTLAND
Authorized official JEN LEWANDOWSKI - (DHA UBO)
Entity Organization
Organization subpart Yes
Enumeration date 12/13/2005
Last updated 06/17/2025 - About 12 months ago
Sole proprietor1 Not specified
Identifiers
  • NM Other: 32-08926 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 377TH MEDGRP-KIRTLAND

There are currently no reviews for 377TH MEDGRP-KIRTLAND


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