NPI Index

366TH MEDGRP-MOUNTAIN HOME

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

Active Organization
NPI: 1063487791

Practice Address

90 HOPE DRIVE BLDG 6000
366 MEDICAL GROUP
Mountain Home Afb, ID 83648

Phone: (208) 828-7470

Specialties

Specialty Code Primary License
Clinic/Center - Military/U.S. Coast Guard Outpatient 261QM1100X No -
Military/U.S. Coast Guard Pharmacy 332000000X No -
Clinic/Center - Military and U.S. Coast Guard Ambulatory Procedure 261QM1101X Yes -

Frequently Asked Questions

NPI 1063487791 is the National Provider Identifier for 366TH MEDGRP-MOUNTAIN HOME, a Clinic/Center - Military and U.S. Coast Guard Ambulatory Procedure provider located in Mountain Home Afb, ID. This NPI was enumerated on February 17, 2006.

Quick Facts

NPI
1063487791
Type
Organization
Enumerated
Feb 17, 2006
Last Updated
Jun 17, 2025

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