Organization
56TH MEDICAL GROUP SGSL
Active
Other names
LUKE ER MOD PHCY
Organization subpart
No
Provider details
NPI number
Authorized official
HECTOR MORALES (CHIEF DHA PASS)
(210) 536-6650
Entity
Organization
Contact information
Practice address
7219 N LITCHFIELD RD, BLDG 1130 RM C04, LUKE AFB, AZ 85309-1529
(623) 856-3068
(623) 856-6120
Mailing address
7219 N LITCHFIELD RD, BLDG 1130 RM C04, LUKE AFB, AZ 85309-1529
(623) 856-3068
(623) 856-6120
Taxonomy
Speciality
Code
Description
License number
State
332000000X
Military/U.S. Coast Guard Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1990498
PK
—
Enumeration date
09/22/2006
Last updated
03/30/2016
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