Organization
325TH MEDICAL GROUP SGSL
Active
Other names
TYNDALL MAIN PROVIDER PHCY
Organization subpart
No
Provider details
NPI number
Authorized official
HECTOR MORALES (CHIEF DHA PASS)
(210) 536-6650
Entity
Organization
Contact information
Practice address
340 MAGNOLIA CIR, TYNDALL AFB, FL 32403-5604
(850) 283-7050
(850) 283-7061
Mailing address
340 MAGNOLIA CIR, TYNDALL AFB, FL 32403-5604
(850) 283-7050
(850) 283-7061
Taxonomy
Speciality
Code
Description
License number
State
332000000X
Military/U.S. Coast Guard Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2014088
PK
—
Enumeration date
12/20/2006
Last updated
09/26/2016
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