Organization
WALTER REED NATIONAL MILITARY MED CENTER
Active
Other names
SUGAR GROVE PHCY
Organization subpart
No
Provider details
NPI number
Authorized official
HECTOR MORALES (CHIEF DHA PASS)
(210) 536-6650
Entity
Organization
Contact information
Practice address
BMC BLDG 63, SUGAR GROVE, WV 26815
(304) 249-6380
(304) 249-6379
Mailing address
BMC BLDG 63, SUGAR GROVE, WV 26815
(304) 249-6380
(304) 249-6379
Taxonomy
Speciality
Code
Description
License number
State
332000000X
Military/U.S. Coast Guard Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2111427
PK
—
Enumeration date
09/22/2006
Last updated
01/20/2016
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