Organization
628TH MEDGRP-CHARLESTON
Active
Parent organization
628TH MEDGRP-CHARLESTON
Other names
DOD CHARLESTON AFB PHARMACY
Organization subpart
Yes
Provider details
NPI number
Legal business name
628TH MEDGRP-CHARLESTON
Authorized official
HECTOR MORALES (CHIEF DHA PASS)
(210) 536-6650
Entity
Organization
Contact information
Practice address
204 W HILL BLVD BLDG 364, CHARLESTON AFB, SC 29404-4704
(843) 963-6805
(843) 963-6727
Mailing address
628 MEDICAL GROUP C/O RMO OFFICE, 204 W. HILL BLVD. BLDG 364, CHARLESTON AFB, SC 29404-4704
(843) 963-6805
(843) 963-6727
Taxonomy
Speciality
Code
Description
License number
State
332000000X
Military/U.S. Coast Guard Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2146517
PK
—
Enumeration date
06/26/2014
Last updated
05/30/2025
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