Organization
AHC LYSTER-RUCKER
Active
Parent organization
AHC LYSTER-RUCKER
Other names
Rucker Dental Phcy
Organization subpart
Yes
Provider details
NPI number
Legal business name
AHC LYSTER-RUCKER
Authorized official
MR. HECTOR MORALES (MANAGER DOD PHARMACY OPS CENTER)
(210) 221-8274
Entity
Organization
Contact information
Practice address
5TH AVE, BLDG 4405, FT. RUCKER, AL 36362-5333
(334) 255-7178
Mailing address
301 ANDREWS RD, ATTN MCXY-RM-TPCP, FORT RUCKER, AL 36362
(334) 255-7244
Taxonomy
Speciality
Code
Description
License number
State
332000000X
Military/U.S. Coast Guard Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0129709
NCPDP
—
Enumeration date
02/06/2008
Last updated
06/24/2025
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