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Organization

FT MEADE MEDDAC

Active
Parent organization
FT MEADE MEDDAC
Other names
DoD FT MEADE ePhcy, DOD FT MEADE PHARMACY
Organization subpart
Yes

Provider details

NPI number
Legal business name
FT MEADE MEDDAC
Authorized official
HECTOR MORALES (CHIEF DHA PASS)
(210) 536-6650
Entity
Organization

Contact information

Practice address
2480 LLEWELLYN AVE STE 5800, KIMBROUGH AMBULATORY CARE CENTER, FORT MEADE, MD 20755-5129
(301) 677-8800
(301) 677-8456
Mailing address
KIMBROUGH ACC MILITARY MTF, CO CDR USAMEDDAC MCXR-BD 2480 LUWELLYN AVE STE 5800, FT MEADE, MD 20755-5129
(301) 677-8800
(301) 677-8456

Taxonomy

Speciality
Code
Description
License number
State
332000000X
Military/U.S. Coast Guard Pharmacy
Primary
333600000X
Pharmacy

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2146217
PK
Enumeration date
06/13/2014
Last updated
05/30/2025
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