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366th Medical Group Sgsl
Pharmacy in Mountain Home Afb, Idaho
NPI 1811094667

366th Medical Group Sgsl is a Pharmacy based in Mountain Home Afb, ID. 366th Medical Group Sgsl practices in Mountain Home Afb, ID. The NPI Number for 366th Medical Group Sgsl is 1811094667 and holds a License No. (Idaho).

The current practice location address for 366th Medical Group Sgsl is 90 Hope Dr, Mountain Home Afb, ID and can be reached out via phone at 208-828-7480 and via fax at 208-828-3785.

Location: 90 Hope Dr, Mountain Home Afb, ID, 83648-1057
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1811094667
Provider Name
366th Medical Group Sgsl
Credential
Provider Entity Type
Organization
Address
90 Hope Dr, Mountain Home Afb, ID, 83648-1057
Phone Number
208-828-7480
Fax Number
208-828-3785
Provider Enumeration Date
09/20/2006
Last Update Date
03/12/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
2021727 01 PK
institution
Provider Business Practice Location Address Details
Address
90 Hope Dr
City
Mountain Home Afb
State
Idaho
Zip
83648-1057
Phone Number
208-828-7480
Fax Number
208-828-3785
person
Provider Business Mailing Address Details
Address
90 Hope Dr
City
Mountain Home Afb
State
Idaho
Zip
83648-1057
Phone Number
208-828-7480
Fax Number
208-828-3785
person
Provider's Taxonomy Details 1
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.
person
Provider's Taxonomy Details 2
Type
Suppliers
Classification
Pharmacy
Speciality
-
Taxonomy
333600000X
License No.
()
Definition
A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located.
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