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3RD MEDICAL SUPPORT SQUADRON SGSL
>> Military/U.S. Coast Guard Pharmacy >> SuppliersRegistrant NPI Number: 1295834356
Organizational Registrant:Organization Name: 3RD MEDICAL SUPPORT SQUADRON SGSL
Organization is not Subpart
Authorized Official: HECTOR MORALES CHIEF DHA PASS 210--53-66650
Organization is not Subpart
Authorized Official: HECTOR MORALES CHIEF DHA PASS 210--53-66650
Location and contact information for practice:
5955 ZEAMER AVE ELMENDORF AFB, AK 99506-3702 US
Tel: 907-580-1175 Fax: 907-580-1176
Tel: 907-580-1175 Fax: 907-580-1176
Contact information for business:
5955 ZEAMER AVE ELMENDORF AFB, AK 99506-3702 US
Tel: 907-580-1175 Fax: 907-580-1176
Tel: 907-580-1175 Fax: 907-580-1176
Registration Information:
NPI: 1295834356
Entity Type: Organization
Entity Type: Organization
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 332000000X | Suppliers Military/U.S. Coast Guard Pharmacy |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
| PK | 1996975 | 01 |
