Provider Demographics
NPI:1588040224
Name:48TH MEDICAL GROUP, RAFL, USAF
Entity Type:Organization
Organization Name:48TH MEDICAL GROUP, RAFL, USAF
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HOSPITAL COMMANDER
Authorized Official - Prefix:DR
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:163-852-8001
Mailing Address - Street 1:CHESTER STREET, LAKENHEATH
Mailing Address - Street 2:
Mailing Address - City:BRANDON
Mailing Address - State:UNITED KINGDOM
Mailing Address - Zip Code:IPS7 9PS
Mailing Address - Country:GB
Mailing Address - Phone:163-852-8659
Mailing Address - Fax:
Practice Address - Street 1:CHESTER STREET, LAKENHEATH
Practice Address - Street 2:
Practice Address - City:BRANDON
Practice Address - State:UNITED KINGDOM
Practice Address - Zip Code:IPS7 9PS
Practice Address - Country:GB
Practice Address - Phone:163-852-8659
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-05
Last Update Date:2015-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA12487286500000X, 291900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes286500000XHospitalsMilitary Hospital
No291900000XLaboratoriesMilitary Clinical Medical Laboratory