366TH MEDGRP-MOUNTAIN HOME
NPI 1063487791
Clinic/Center - Military and U.S. Coast Guard Ambulatory Procedure in Mountain Home Afb, ID
NPI Status: Active since February 17, 2006
Contact Information
90 HOPE DRIVE BLDG 6000
366 MEDICAL GROUP
MOUNTAIN HOME AFB, ID
ZIP 83648
Phone: (208) 828-7470
Fax: (208) 828-2753
- Organization
- Clinic/Center
- Military and U.S. Coast Guard Ambulatory...
About 366TH MEDGRP-MOUNTAIN HOME
This page provides the complete NPI Profile along with additional information for 366th Medgrp-mountain Home, a provider established in Mountain Home Afb, Idaho operating as a Clinic/center, focusing in military and u.s. coast guard ambulatory procedure . The healthcare provider is registered in the NPI registry with number 1063487791 assigned on February 2006. The practitioner's primary taxonomy code is 261QM1101X. The provider is registered as an organization and their NPI record was last updated one year ago. The authorized official of this NPI record is Jen Lewandowski (Dha Ubo)
- NPI
- 1063487791
- Provider Name
- 366TH MEDGRP-MOUNTAIN HOME
- Entity Type
- Organization
- Location Address
- 90 HOPE DRIVE BLDG 6000 366 MEDICAL GROUP MOUNTAIN HOME AFB, ID 83648
- Location Phone
- (208) 828-7470
- Location Fax
- (208) 828-2753
- Mailing Address
- 90 HOPE DRIVE BLDG 6000 366 MEDICAL GROUP SGSR MOUNTAIN HOME AFB, ID 83648
- Mailing Phone
- (208) 828-7470
- Mailing Fax
- (208) 828-2753
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- Yes
- Enumeration Date
- 02-17-2006
- Last Update Date
- 06-17-2025
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Clinic/Center Military and U.S. Coast Guard Ambulatory Procedure
- Taxonomy Code
- 261QM1101X
- Type
- Ambulatory Health Care Facilities
- Taxonomy Description
- That part of a fixed (non-temporary, non-deployed) DoD or Coast Guard entity furnishing surgical procedures requiring medically supervised recovery. Similar to a civilian ambulatory surgical center. May be in shared resources with a DoD or Coast Guard Clinic or a DoD Hospital. Does not include items issued directly to a patient from an outpatient pharmacy or patient transport. Includes initial take home pharmaceuticals.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 261QM1100X | Ambulatory Health Care Facilities | Clinic/Center | |
| 2 | 332000000X | Suppliers | Military/U.S. Coast Guard Pharmacy |
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 8072078 | MEDICAID (05) | ID | |
| 1306845 | OTHER (01) | ID | NCPDP |
Reviews for 366TH MEDGRP-MOUNTAIN HOME
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1063487791, we treat the final digit (1) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 69. The final step is to find the difference between that total and the next multiple of ten (70 - 69 = 1).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 69 is 70. The difference is the calculated check digit.
Other Providers at the Same Location
The following 2 providers are registered at the same or a nearby location.
MOUNTAIN HOME, ID 83648
MOUNTIAN HOME AFB, ID 83648
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1063487791, enumerated as an "organization" on February 17, 2006.
The provider is located at 90 HOPE DRIVE BLDG 6000 366 MEDICAL GROUP MOUNTAIN HOME AFB, ID 83648 and the phone number is (208) 828-7470.
Clinic/Center with taxonomy code 261QM1101X and a focus in Military and U.S. Coast Guard Ambulatory Procedure.
The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.
