Organization
90TH MEDGRP-FE WARREN
Active
Parent organization
90TH MEDGRP-FE WARREN
Other names
DOD FE WARREN PHARMACY
Organization subpart
Yes
Provider details
NPI number
Legal business name
90TH MEDGRP-FE WARREN
Authorized official
HECTOR MORALES (CHIEF DHA PASS)
(210) 536-6650
Entity
Organization
Contact information
Practice address
6900 ALDEN DR BLDG 160, FE WARREN AFB, WY 82005-2945
(307) 773-3638
(307) 773-3731
Mailing address
90TH MEDICAL GROUP-UNITED STATES AIR FORCE, 6900 ALDEN DR., FE WARREN AFB, WY 82005-3906
(307) 773-3638
(307) 773-4589
Taxonomy
Speciality
Code
Description
License number
State
332000000X
Military/U.S. Coast Guard Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2146759
PK
—
Enumeration date
07/09/2014
Last updated
06/13/2025
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