Organization
45TH MEDGRP-PATRICK
Active
Parent organization
45TH MEDGRP-PATRICK
Other names
DoD PATRICK ePhcy
Organization subpart
Yes
Provider details
NPI number
Legal business name
45TH MEDGRP-PATRICK
Authorized official
HECTOR MORALES (CHIEF DHA PASS)
(210) 536-6650
Entity
Organization
Contact information
Practice address
1381 S PATRICK DR, PATRICK AFB, FL 32925-3606
(321) 494-3988
(321) 494-7117
Mailing address
45TH MEDICAL GROUP-SGAM, 1381 S. PATRICK DR., PATRICK AFB, FL 32925-3606
(321) 494-3988
(321) 494-3999
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
—
2146750
PK
—
Enumeration date
07/09/2014
Last updated
06/11/2025
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