Organization
21ST MEDICAL GROUP
Active
Other names
SCHRIEVER REFILL PCTR PHCY
Organization subpart
No
Provider details
NPI number
Authorized official
HECTOR MORALES (CHIEF DHA PASS)
(210) 536-6650
Entity
Organization
Contact information
Practice address
220 FALCON PKWY BLDG 220, COLORADO SPRINGS, CO 80912-5005
(719) 567-4423
(719) 567-4817
Mailing address
21ST MEDICAL GROUP, C/O RMO OFFICE 559 VINCENT ST, PETERSON AFB, CO 80914-1541
Taxonomy
Speciality
Code
Description
License number
State
332000000X
Military/U.S. Coast Guard Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2151923
PK
—
Enumeration date
05/14/2015
Last updated
01/15/2016
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