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Organization
21 MEDICAL GROUP
Active
Organization
21 MEDICAL GROUP
Active
Other names
PETERSON AFB REFILL PROCESSING CTR
Organization subpart
No
Provider details
NPI number
Authorized official
HECTOR MORALES (CHIEF DHA PASS)
(210) 536-6650
Entity
Organization
Contact information
Practice address
8119 PARK DR, USAF ACADEMY, CO 80840-2397
(719) 333-0545
(719) 333-0544
Mailing address
8119 PARK DR, USAF ACADEMY, CO 80840-2397
(719) 333-0545
(719) 333-0544
Taxonomy
Speciality
Code
Description
License number
State
332000000X
Military/U.S. Coast Guard Pharmacy
Primary
—
NULL
333600000X
Pharmacy
—
NULL
Other
Enumeration date
09/20/2006
Last updated
01/13/2016
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