Organization
42D MEDGRP-MAXWELL
Active
Parent organization
42D MEDGRP-MAXWELL
Other names
DoD MAXWELL ePhcy
Organization subpart
Yes
Provider details
NPI number
Legal business name
42D MEDGRP-MAXWELL
Authorized official
HECTOR MORALES (DHA POD)
(210) 536-6118
Entity
Organization
Contact information
Practice address
300 TWINING ST, MAXWELL AFB, AL 36112-6027
(334) 953-9333
(334) 953-5272
Mailing address
USAF-MAXWELL HOSPITAL/SGL, 300 SOUTH TWINING ST. BLDG. 760, MAXWELL AFB, AL 36112-0000
(334) 953-9333
(334) 953-5272
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
—
2147340
PK
—
Enumeration date
08/15/2014
Last updated
07/25/2025
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