Organization
21ST MEDGRP-PETERSON
Active
Parent organization
21ST MEDGRP-PETERSON
Other names
DoD SCHRIEVER ePhcy
Organization subpart
Yes
Provider details
NPI number
Legal business name
21ST MEDGRP-PETERSON
Authorized official
HECTOR MORALES (CHIEF DHA PASS)
(210) 536-6650
Entity
Organization
Contact information
Practice address
220 FALCON PKWY, SCHRIEVER AFB, CO 80912-5005
(719) 567-4423
(719) 567-4817
Mailing address
21ST MEDICAL GROUP C/O RMO OFFICE, 559 VINCENT ST, PETERSON AFB, CO 80914-1541
(719) 567-4423
(719) 567-4817
Taxonomy
Speciality
Code
Description
License number
State
332000000X
Military/U.S. Coast Guard Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2146548
PK
—
Enumeration date
06/26/2014
Last updated
06/13/2025
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