Organization
60TH MEDGRP-TRAVIS
Active
Parent organization
60TH MEDGRP-TRAVIS
Organization subpart
Yes
Provider details
NPI number
Legal business name
60TH MEDGRP-TRAVIS
Authorized official
HECTOR MORALES (MGR PHRMCY OPERATIONS CNTR)
(210) 221-8443
Entity
Organization
Contact information
Practice address
5342 DUDLEY BLVD, MCCLELLAN, CA 95652-1012
(916) 561-7430
(916) 561-7475
Mailing address
5342 DUDLEY BLVD, MCCLELLAN, CA 95652-1012
Taxonomy
Speciality
Code
Description
License number
State
332100000X
Department of Veterans Affairs (VA) Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0585147
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
09/20/2006
Last updated
03/12/2025
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