Organization
AMC MADIGAN-FT LEWIS
Active
Parent organization
AMC MADIGAN-FT LEWIS
Other names
JBLM PUYALLUP CMH PHARMACY, MADIGAN PUYALLUP PHCY
Organization subpart
Yes
Provider details
NPI number
Legal business name
AMC MADIGAN-FT LEWIS
Authorized official
HECTOR MORALES (DEPUTY DIRECTOR OF PHARMACY OPS)
(210) 221-8274
Entity
Organization
Contact information
Practice address
10507 156TH ST E, SUITE 112, PUYALLUP, WA 98374-9361
(253) 307-5433
Mailing address
9040A JACKSON AVE, ATTN: MCHJ-CSA-U, TACOMA, WA 98431-0001
(253) 968-6598
Taxonomy
Speciality
Code
Description
License number
State
332000000X
Military/U.S. Coast Guard Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1841390077
PARENT BILLING FACILITY NPI
—
01
—
1851605356
FACILITY NPI
—
01
—
4933924
NCPDP
—
Enumeration date
02/02/2011
Last updated
06/13/2025
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