Healthcare Provider Details
I. General information
NPI: 1578119087
Provider Name (Legal Business Name): 6TH MEDICAL GROUP THIRD PARTY COLLECTIONS
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/12/2019
Last Update Date: 02/18/2020
Certification Date: 02/18/2020
Deactivation Date:
Reactivation Date:
III. Provider practice location address
9208 KING PALM DR
TAMPA FL
33619-1328
US
IV. Provider business mailing address
3250 ZEMKE AVE BLDG 1075
TAMPA FL
33621-5023
US
V. Phone/Fax
- Phone: 813-827-9126
- Fax:
- Phone: 813-827-9126
- Fax: 813-828-0088
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 332000000X |
| Taxonomy | Military/U.S. Coast Guard Pharmacy |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ROSEMARY
GONZALEZ
Title or Position: MTF SUPPORT
Credential:
Phone: 210-536-6096