Organization
EVANS ARMY COMMUNITY HOSPITAL
Active
Other names
CARSON COMMISSARY PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
HECTOR MORALES (DEPUTY DIRECTOR PHCY OPS CTR)
(210) 221-8443
Entity
Organization
Contact information
Practice address
6351 WETZEL AVE, BLDG 1525, FT CARSON, CO 80913-4188
(719) 524-1060
(719) 526-7749
Mailing address
EVANS ARMY COMMUNITY HOSPITAL, 1650 COCHRANE CIR ATTN THIRD PARTY OFFICE, FT CARSON, CO 80913-4603
(210) 221-8274
Taxonomy
Speciality
Code
Description
License number
State
332000000X
Military/U.S. Coast Guard Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2003338
PK
—
Enumeration date
09/21/2006
Last updated
01/20/2015
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