| NPI | 1174507420 |
|---|---|
| Doing Business As | 460TH MEDICAL GROUP |
| Entity Type | Organization |
| Authorized Contact | PAMELA RENEE PARKS Director, Qm/Rm/Msm 720-277-9493 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 261QM1100X Clinic/Center, MilitaryU.S. Coast Guard Outpatient |
| 261QM1101X Clinic/Center, Military and U.S. Coast Guard Ambulatory Procedure | |
| 332000000X MilitaryU.S. Coast Guard Pharmacy | |
| Enumeration Date | 2005-11-30 |
| Last Update Date | 2022-12-14 |