17TH MEDICAL GROUP
NPI 1104805142
Clinic/center, Military And U.s. Coast Guard Ambulatory Procedure in Goodfellow Afb,


Quality Rating: 100 out of 100 score

NPI Status: Active since January 10, 2006

Contact Information

271 Fort Richardson Ave
Goodfellow Afb,
Post Code: 76908
Phone: (325) 654-5974
Fax: (325) 654-3121

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17th Medical Group in Goodfellow Afb - Clinic/Center, Military and U.S. Coast Guard Ambulatory Procedure

17th Medical Group is a Clinic/Center, Military and U.S. Coast Guard Ambulatory Procedure in Goodfellow Afb, . 17th Medical Group practices all healthcare services and medical treatments related to Clinic/Center, Military and U.S. Coast Guard Ambulatory Procedure. The NPI Number for 17th Medical Group is 1104805142. The last update date is 2010-11-15.

17th Medical Group's current location address is 271 Fort Richardson Ave, Goodfellow Afb, . You can contact this provider via phone number (325) 654-5974 and fax number (325) 654-3121. The mailing address for 17th Medical Group is 271 Fort Richardson Ave, Goodfellow Afb, . To know further, please read the information below!

About GREGORY MERRITT

NPI
1104805142
Provider Legal Name
17TH MEDICAL GROUP
Other Organization Name
17TH MEDICAL GROUP
Other Name Type
-
Entity Type
Organization
Location Address
271 Fort Richardson Ave, Goodfellow Afb,
Location Phone
(325) 654-5974
Location Fax
(325) 654-3121
Mailing Address
271 Fort Richardson Ave, Goodfellow Afb, Texas(TX)
Mailing Phone
325-654-5974
Mailing Fax
325-654-3121
Enumeration Date
2006-01-10
Last Update Date
2010-11-15
Code Navigator

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Clinic/Center, MilitaryU.S. Coast Guard Outpatient

Taxonomy Code
261QM1100X
Type
-
License No.
-
License State
Texas (TX)
Taxonomy Description
-

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No. Taxonomy Code Type Classification /
Specialization
License No. (State)
1 261QM1101X Military and U.S. Coast Guard Ambulatory Procedure Clinic/Center

Clinic/Center, Military and U.S. Coast Guard Ambulatory Procedure

()
2 332000000X Military/U.S. Coast Guard Pharmacy

MilitaryU.S. Coast Guard Pharmacy

()

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
4596740 Other (non-Medicare) (01) Texas (TX) NCPDP

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NPI Validation Check Digit Calculation


The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1104805142
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
21041601018
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. 21041601018
2 + 1 + 0 + 4 + 1 + 6 + 0 + 1 + 0 + 1 + 8 + 24 = 48
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
50 - 48 = 2 2

The NPI number 1104805142 is valid because the calculated check digit 2 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location


The following 5 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1013910058 WESTHEIMER VISION ASSOCIATES, PC
Organization
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713-781-3517
1093718025 YODORINCMISSIONPLAZAPHARMACY
Organization
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MISSION, Texas (TX)
956-581-8833
1093718033 TARRANT MEDICAL IMAGING, LLC
Organization
Physiological Laboratory 1894 GEORGETOWN RD
HUDSON, Ohio (OH)
330-653-3968
1063415008 ARLINGTON MEDICAL IMAGING LLC
Organization
Physiological Laboratory 3025 MATLOCK RD
ARLINGTON, Texas (TX)
817-467-6099
1023011210 MAUREEN STANEK POLAKOWSKI
Individual
Nurse Practitioner 4835 LBJ FWY STE 900
DALLAS, Texas (TX)
844-941-3087