# 366TH MEDGRP-MOUNTAIN HOME

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** 366TH MEDGRP-MOUNTAIN HOME
- **Other names:** DoD MT HOME ePhcy
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1144636515
- **Legal business name:** 366TH MEDGRP-MOUNTAIN HOME
- **Authorized official:** HECTOR MORALES (CHIEF DHA PASS)
- **Authorized official phone:** (210) 536-6650

## Contact information

- **Practice address:** 90 HOPE DR BLDG 6000, MOUNTAIN HOME AFB, ID 83648-1062
- **Practice address phone:** (208) 828-7521
- **Practice address fax:** (208) 828-7676
- **Mailing address:** 90 HOPE DR BLDG 6000, MTN HOME AFB, ID 83648-1062
- **Mailing address phone:** (208) 828-7900
- **Mailing address fax:** (208) 828-7676

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332000000X | Military/U.S. Coast Guard Pharmacy | — | NULL | Yes |
| 333600000X | Pharmacy | — | NULL | — |

## Other

- **Enumeration date:** 07/07/2014
- **Last updated:** 09/15/2026