12th Medical Group Randolph

NPI 1316911597 - Military/U.S. Coast Guard Pharmacy - 332000000X

NPI Details
NPI 1316911597
Enumeration Date 02/15/2006
Last Updated 11/15/2010
Entity Type Healthcare Provider
Active Over 10 years ago
Authorized Information
Name SERENA LYNN SERENA
Position AIR FORCE UNIFORM BUSINESS OFFICE
Phone (210) 652-2420
Fax (210) 652-6571
Practice Location
221 3RD ST W
BLDG 1040
RANDOLPH A F B TX, 78150-4800, US
Phone (210) 652-2420
Fax (210) 652-6571
Business Location
221 3RD ST W
BLDG 1040
RANDOLPH A F B TX, 78150-4800, US
Phone (210) 652-2420
Fax (210) 652-6571
Toxanomy
Taxonomy Code 332000000X
License State
License Number
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According to our database, 12th Medical Group Randolph NPI is 1316911597, taxonomy code is 332000000X 12th Medical Group Randolph physically located at 221 3rd St W, Randolph A F B TX, 78150-4800. NPI Number 1033115704 has the healthcare provider type.

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1316911597 NPI number is provided on an as is basis without warranty of any kind. 1316911597 is maintained by the National Plan & Provider Enumeration System. The contents of 12th Medical Group Randolph are for informational purposes only.