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19th Mdss Sgsr
Military/U.S. Coast Guard Pharmacy in Lr Afb, Arkansas
NPI 1073591830

19th Mdss Sgsr is a Military/U.S. Coast Guard Pharmacy based in Lr Afb, AR. 19th Mdss Sgsr practices in Lr Afb, AR. The NPI Number for 19th Mdss Sgsr is 1073591830 and holds a License No. (Arkansas).

The current practice location address for 19th Mdss Sgsr is 1090 Arnold Dr, Lr Afb, AR and can be reached out via phone at 501-987-7414 and via fax at 501-987-7310. You can also correspond with 19th Mdss Sgsr through the mailing address at 1090 ARNOLD DR, LR AFB, AR - 72099-4933 (mailing address contact number: 501-987-7414).

Location: 1090 Arnold Dr, Lr Afb, AR, 72099-4933
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1073591830
Provider Name
19th Mdss Sgsr
Credential
Provider Entity Type
Organization
Address
1090 Arnold Dr, Lr Afb, AR, 72099-4933
Phone Number
501-987-7414
Fax Number
501-987-7310
Provider Enumeration Date
01/03/2006
Last Update Date
03/12/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
420846 01 AR NCPDP
institution
Provider Business Practice Location Address Details
Address
1090 Arnold Dr
City
Lr Afb
State
Arkansas
Zip
72099-4933
Phone Number
501-987-7414
Fax Number
501-987-7310
person
Provider Business Mailing Address Details
Address
1090 Arnold Dr
City
Lr Afb
State
Arkansas
Zip
72099-4933
Phone Number
501-987-7414
Fax Number
501-987-7310
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Military/U.S. Coast Guard Outpatient
Taxonomy
261QM1100X
License No.
()
Definition
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.
person
Provider's Taxonomy Details 2
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Military and U.S. Coast Guard Ambulatory Procedure
Taxonomy
261QM1101X
License No.
()
Definition
That part of a "fixed" (non-temporary, non-deployed) DoD or Coast Guard entity furnishing surgical procedures requiring medically supervised recovery. Similar to a civilian ambulatory surgical center. May be in shared resources with a DoD or Coast Guard Clinic or a DoD Hospital. Does not include items issued directly to a patient from an outpatient pharmacy or patient transport. Includes initial "take home" pharmaceuticals.
person
Provider's Taxonomy Details 3
Type
Suppliers
Classification
Military/U.S. Coast Guard Pharmacy
Speciality
-
Taxonomy
332000000X
License No.
()
Definition
A Department of Defense (DoD) or U.S. Coast Guard entity whose primary function is to store, prepare and dispense pharmaceuticals and other associated items to Uniformed Services beneficiaries. These pharmacies may be associated with a DoD or U.S. Coast Guard clinic, DoD Hospital or freestanding. Usually associated with outpatient services.
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