Organization
96TH MEDICAL SUPPORT SQUADRON
Active
Other names
EGLIN DUKE FC PHCY
Organization subpart
No
Provider details
NPI number
Authorized official
HECTOR MORALES (CHIEF DHA PASS)
(210) 536-6650
Entity
Organization
Contact information
Practice address
3120 A. TALON WAY, EGLIN AFB FLD #3, FL 32542
(850) 883-1978
Mailing address
307 BOATNER RD STE 114, EGLIN AFB, FL 32542-1302
(850) 883-8000
Taxonomy
Speciality
Code
Description
License number
State
332000000X
Military/U.S. Coast Guard Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2149699
PK
—
Enumeration date
01/20/2015
Last updated
04/06/2016
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