# MT HOME REFILL PHCY

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1801959473
- **Authorized official:** HECTOR MORALES (PHARMACY OPERATIONS CENTER MGR)
- **Authorized official phone:** (210) 221-8443

## Contact information

- **Practice address:** 90 HOPE DR, MOUNTAIN HOME AFB, ID 83648
- **Practice address phone:** (208) 828-7480
- **Practice address fax:** (208) 828-3785
- **Mailing address:** 90 HOPE DR, MOUNTAIN HOME AFB, ID 83648
- **Mailing address phone:** (208) 828-7480
- **Mailing address fax:** (208) 828-3785

## Taxonomy

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

## Other

- **Enumeration date:** 12/18/2006
- **Last updated:** 08/25/2008