Organization
97TH MEDGRP-ALTUS
Active
Parent organization
97TH MEDGRP-ALTUS
Other names
DoD ALTUS ePhcy
Organization subpart
Yes
Provider details
NPI number
Legal business name
97TH MEDGRP-ALTUS
Authorized official
HECTOR MORALES (DHA POD)
(210) 536-6118
Entity
Organization
Contact information
Practice address
301 N 1ST ST, BLDG 46, ALTUS AFB, OK 73523-5004
(580) 481-5258
(580) 481-7420
Mailing address
97 MDG MSC FUND C/O MSC TREASURER, TSG MARIA DELEON 301 N FIRST ST. BLDG 46, ALTUS AFB, OK 73523
(580) 481-5258
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
—
2145934
PK
—
Enumeration date
05/28/2014
Last updated
07/28/2025
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