Organization
ANDERSEN PHCY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HECTOR MORALES (MGR PHRMCY OPERATIONS CNTR)
(210) 221-8443
Entity
Organization
Contact information
Practice address
BLDG 26000 SANTA ROSA, ANDERSEN AFB, GU 96543
(671) 366-5271
(671) 366-1229
Mailing address
BLDG 26000 SANTA ROSA, ANDERSEN AFB, GU 96543
Taxonomy
Speciality
Code
Description
License number
State
332000000X
Military/U.S. Coast Guard Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5411739
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
09/22/2006
Last updated
06/17/2008
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