Organization
96TH MEDICAL SUPPORT SQUADRON SGSL
Active
Other names
ARNOLD PHCY
Organization subpart
No
Provider details
NPI number
Authorized official
HECTOR MORALES (CHIEF DHA PASS)
(210) 536-6650
Entity
Organization
Contact information
Practice address
225 FIRST ST BLDG 225, ARNOLD AFB, TN 37389
(931) 454-5351
(931) 454-3392
Mailing address
96TH MEDICAL SUPPORT SQUADRON, 307 BOATNER RD STE 114, ARNOLD AFB, TN 32542-1302
(931) 454-5351
(931) 454-3392
Taxonomy
Speciality
Code
Description
License number
State
332000000X
Military/U.S. Coast Guard Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2092941
PK
—
Enumeration date
09/22/2006
Last updated
06/02/2015
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