# 316TH MEDGRP-MALCOLM GROW

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** 316TH MEDGRP-MALCOLM GROW
- **Other names:** DoD BOLLING ePhcy
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1861804551
- **Legal business name:** 316TH MEDGRP-MALCOLM GROW
- **Authorized official:** WILLIAM MICHAEL CONDON (DHA FINANCIAL MANAGER)
- **Authorized official phone:** (240) 401-3643

## Contact information

- **Practice address:** 238 BROOKLEY AVE SW, 579TH MEDICAL GROUP, BOLLING AFB, DC 20032-7704
- **Practice address phone:** (202) 404-7742
- **Practice address fax:** (202) 404-1216
- **Mailing address:** 1060 W PERIMETER RD, JB ANDREWS, MD 20762-6602
- **Mailing address phone:** (202) 404-7742
- **Mailing address fax:** (202) 404-1216

## Taxonomy

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

## Other

- **Enumeration date:** 05/29/2014
- **Last updated:** 03/12/2025