Provider Demographics
NPI:1578119087
Name:6TH MEDICAL GROUP THIRD PARTY COLLECTIONS
Entity Type:Organization
Organization Name:6TH MEDICAL GROUP THIRD PARTY COLLECTIONS
Other - Org Name:DOD SABAL PARK EPHCY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MTF SUPPORT
Authorized Official - Prefix:
Authorized Official - First Name:ROSEMARY
Authorized Official - Middle Name:
Authorized Official - Last Name:GONZALEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-536-6096
Mailing Address - Street 1:3250 ZEMKE AVE BLDG 1075
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33621-5023
Mailing Address - Country:US
Mailing Address - Phone:813-827-9126
Mailing Address - Fax:813-828-0088
Practice Address - Street 1:9208 KING PALM DR
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33619-1328
Practice Address - Country:US
Practice Address - Phone:813-827-9126
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:6TH MEDICAL GROUP THIRD PARTY COLLECTIONS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-08-12
Last Update Date:2020-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332000000XSuppliersMilitary/U.S. Coast Guard Pharmacy