Organization
27TH SPECIAL OPS MEDGRP-CANNON
Active
Parent organization
27TH SPECIAL OPS MEDGRP-CANNON
Other names
DoD CANNON ePhcy
Organization subpart
Yes
Provider details
NPI number
Legal business name
27TH SPECIAL OPS MEDGRP-CANNON
Authorized official
HECTOR MORALES (CHIEF DHA PASS)
(210) 536-6650
Entity
Organization
Contact information
Practice address
224 WEST D. L. INGRAM BLVD, BLDG 1408, CANNON AFB, NM 88103-5103
(575) 784-4912
(575) 784-7494
Mailing address
27TH MEDICAL GROUP SGSL, 208 W. D.L. INGRAM BLVD. 1ST FLOOR, CANNON AFB, NM 88103
(575) 784-4028
(575) 784-7494
Taxonomy
Speciality
Code
Description
License number
State
332000000X
Military/U.S. Coast Guard Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2147336
PK
—
Enumeration date
08/20/2014
Last updated
09/02/2025
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