Organization
ALTUS PHCY 97TH MDG
Active
Other names
ALTUS PHCY 97TH MDG
Organization subpart
No
Provider details
NPI number
Authorized official
HECTOR MORALES (CHIEF DHA PASS)
(210) 536-6650
Entity
Organization
Contact information
Practice address
301 N 1ST ST, ALTUS AFB, OK 73523-5004
(580) 481-5258
(580) 481-7420
Mailing address
301 N 1ST ST, ALTUS AFB, OK 73523-5004
(580) 481-5258
(580) 481-7420
Taxonomy
Speciality
Code
Description
License number
State
332000000X
Military/U.S. Coast Guard Pharmacy
Primary
—
—
333600000X
Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2074861
PK
—
Enumeration date
09/20/2006
Last updated
02/27/2017
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