71TH Medical Group SGSL

Primary specialty

Military/U.S. Coast Guard PharmacyTaxonomy code 332000000X

Legal business name

71TH MEDICAL GROUP SGSL

Doing business as

Vance Phcy 71St MDG

Practice address

527 Gott Rd
Enid, OK 73705-5103

Phone

(580) 213-7783

Fax

(580) 213-7995

NPI assigned

Sep 22, 2006

Last updated

Jan 22, 2016By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Hector Morales

Title

Chief Dha Pass

Phone

(210) 536-6650

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• VANCE PHCY 71ST MDG Doing business as

Tax ID family

71St Medgrp-Vance2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• 71St Medgrp-Vance

  • Military/U.S. Coast Guard Outpatient Clinic/Center
  • Enid, OK
  • NPI 1932187838
  NPD tax ID

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1158883200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1453420800000",
    "number": "1710086079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "527 GOTT RD",
            "city": "ENID",
            "state": "OK",
            "postal_code": "737055103",
            "telephone_number": "580-213-7783",
            "fax_number": "580-213-7995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "527 GOTT RD",
            "city": "ENID",
            "state": "OK",
            "postal_code": "737055103",
            "telephone_number": "580-213-7783",
            "fax_number": "580-213-7995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "71TH MEDICAL GROUP SGSL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-22",
        "last_updated": "2016-01-22",
        "status": "A",
        "authorized_official_last_name": "MORALES",
        "authorized_official_first_name": "HECTOR",
        "authorized_official_title_or_position": "CHIEF DHA PASS",
        "authorized_official_telephone_number": "210-536-6650"
    },
    "taxonomies": [
        {
            "code": "332000000X",
            "taxonomy_group": "",
            "desc": "Military/U.S. Coast Guard Pharmacy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2076297",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "VANCE PHCY 71ST MDG",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• 202 Haley Inc. (Veterans Acres Residential Care)
• 2ND Home Adult Daycare, LLC
• 4 R Families Medical Clinic PLLC
• 71St Medgrp-Vance
• 71St Medgrp-Vance (DoD VANCE ePhcy)
• A New Day Nutrition Services LLC
• A Path of Care Hospice III, LLC (A Path of Care Hospice)
• A-Plus Family Medicine, LLC
• Rhema Marie Abercrombie
• Brylyn Adams, LPN

• Military/U.S. Coast Guard Pharmacy in Enid, OK
• Providers in Enid, OK by specialty
• Military/U.S. Coast Guard Pharmacy in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.