Organization
96TH MEDGRP-EGLIN
Active
Parent organization
96TH MEDGRP-EGLIN
Other names
DoD EGLIN ePhcy
Organization subpart
Yes
Provider details
NPI number
Legal business name
96TH MEDGRP-EGLIN
Authorized official
HECTOR MORALES (CHIEF DHA PASS)
(210) 536-6650
Entity
Organization
Contact information
Practice address
96 MEDICAL GROUP SATELLITE PHCY MEMORIAL TRAIL, BLDG. 1758, EGLIN AFB, FL 32542
(850) 883-8000
(850) 883-9131
Mailing address
96 MEDICAL SUPPORT SQUADRON, 307 BOATNER RD. STE 114, EGLIN AFB, FL 32542-1302
(850) 883-8000
(850) 883-9322
Taxonomy
Speciality
Code
Description
License number
State
332000000X
Military/U.S. Coast Guard Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2146012
PK
—
Enumeration date
06/02/2014
Last updated
06/11/2025
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