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377th Medical Group - Kirtland Afb
Military/U.S. Coast Guard Outpatient Clinic/Center in Kirtland Afb, New Mexico
NPI 1912982810

377th Medical Group - Kirtland Afb is a Military/U.S. Coast Guard Outpatient Clinic/Center based in Kirtland Afb, NM and is specialized in Military/U.S. Coast Guard Outpatient. 377th Medical Group - Kirtland Afb practices in Kirtland Afb, NM. The NPI Number for 377th Medical Group - Kirtland Afb is 1912982810 and holds a License No. (New Mexico).

The current practice location address for 377th Medical Group - Kirtland Afb is 2050A Second St Se, Kirtland Afb, NM and can be reached out via phone at 505-846-3605 and via fax at 505-846-3594.

Location: 2050A Second St Se, Kirtland Afb, NM, 87117-5524
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1912982810
Provider Name
377th Medical Group - Kirtland Afb
Credential
Provider Entity Type
Organization
Address
2050A Second St Se, Kirtland Afb, NM, 87117-5524
Phone Number
505-846-3605
Fax Number
505-846-3594
Provider Enumeration Date
12/13/2005
Last Update Date
05/18/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
32-08926 01 NM NCPDP
institution
Provider Business Practice Location Address Details
Address
2050A Second St Se
City
Kirtland Afb
State
New Mexico
Zip
87117-5524
Phone Number
505-846-3605
Fax Number
505-846-3594
person
Provider Business Mailing Address Details
Address
2050A Second St Se
City
Kirtland Afb
State
New Mexico
Zip
87117-5524
Phone Number
505-846-3605
Fax Number
505-846-3594
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.
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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.
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