Organization
92D MEDGRP-FAIRCHILD
Active
Parent organization
92D MEDGRP-FAIRCHILD
Other names
DOD FAIRCHILD PHARMACY
Organization subpart
Yes
Provider details
NPI number
Legal business name
92D MEDGRP-FAIRCHILD
Authorized official
HECTOR MORALES (CHIEF DHA PASS)
(210) 536-6650
Entity
Organization
Contact information
Practice address
701 HOSPITAL LOOP # 135, FAIRCHILD AFB, WA 99011-8704
(509) 247-5567
Mailing address
92ND MEDICAL GROUP, RMO OFFICE 3RD PARTY COLLECTIONS 701 HOSPITAL LOOP, FAIRCHILD AFB, WA 99011-8704
(509) 247-5567
Taxonomy
Speciality
Code
Description
License number
State
332000000X
Military/U.S. Coast Guard Pharmacy
Primary
910569870
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2110194
PK
—
Enumeration date
09/22/2006
Last updated
06/13/2025
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