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Organization
316TH MEDGRP-MALCOLM GROW
Active
Organization
316TH MEDGRP-MALCOLM GROW
Active
Parent organization
316TH MEDGRP-MALCOLM GROW
Other names
DoD BOLLING ePhcy
Organization subpart
Yes
Provider details
NPI number
Legal business name
316TH MEDGRP-MALCOLM GROW
Authorized official
WILLIAM MICHAEL CONDON (DHA FINANCIAL MANAGER)
(240) 401-3643
Entity
Organization
Contact information
Practice address
238 BROOKLEY AVE SW, 579TH MEDICAL GROUP, BOLLING AFB, DC 20032-7704
(202) 404-7742
(202) 404-1216
Mailing address
1060 W PERIMETER RD, JB ANDREWS, MD 20762-6602
(202) 404-7742
(202) 404-1216
Taxonomy
Speciality
Code
Description
License number
State
332000000X
Military/U.S. Coast Guard Pharmacy
Primary
—
NULL
Other
Enumeration date
05/29/2014
Last updated
03/12/2025
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