Organization
MCKINLEYVILLE USCG PHCY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HECTOR MORALES (MGR PHRMCY OPERATIONS CNTR)
(210) 221-8443
Entity
Organization
Contact information
Practice address
1001 LYCOMING AVE, USCG GROUP HUMBOLDT BAY, MCKINLEYVILLE, CA 95519-9308
(707) 839-6179
(707) 839-6178
Mailing address
1001 LYCOMING AVE, USCG GROUP HUMBOLDT BAY, MCKINLEYVILLE, CA 95519-9308
Taxonomy
Speciality
Code
Description
License number
State
332000000X
Military/U.S. Coast Guard Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0586199
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
09/20/2006
Last updated
04/15/2009
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