Organization
62ND MED GRP
Active
Parent organization
62ND MED GRP
Other names
MCCHORD MAIN PHCY
Organization subpart
Yes
Provider details
NPI number
Legal business name
62ND MED GRP
Authorized official
HECTOR MORALES (MGR PHRMCY OPERATIONS CNTR)
(210) 221-8443
Entity
Organization
Contact information
Practice address
690 BARNES BLVD, MCCHORD AFB, WA 98438-1303
(253) 982-2474
(253) 982-8401
Mailing address
690 BARNES BLVD, MCCHORD AFB, WA 98438-1303
Taxonomy
Speciality
Code
Description
License number
State
332000000X
Military/U.S. Coast Guard Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4927197
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
09/22/2006
Last updated
09/01/2009
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