Organization
JAMES A LOVELL FHCC
Active
Other names
GREAT LAKES BURKEY MALL PHCY
Organization subpart
No
Provider details
NPI number
Authorized official
HECTOR MORALES (CHIEF DHA PASS)
(210) 536-6650
Entity
Organization
Contact information
Practice address
3452 GREENBAY RD BLDG 3452, GREAT LAKES, IL 60088
(847) 688-2772
(847) 688-2805
Mailing address
JAMES A LOVELL FHCC, PO BOX 322, NORTH CHICAGO IL, IL 60064
(224) 610-4232
Taxonomy
Speciality
Code
Description
License number
State
332000000X
Military/U.S. Coast Guard Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2025019
PK
—
Enumeration date
09/21/2006
Last updated
08/06/2015
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