Organization
WALTER REED NATIONAL MILITARY MED CENTER
Active
Other names
QUANTICO MAIN PHCY
Organization subpart
No
Provider details
NPI number
Authorized official
HECTOR MORALES (CHIEF DHA PASS)
(210) 536-6650
Entity
Organization
Contact information
Practice address
NMC 2200 LESTER AVENUE, QUANTICO, VA 22134
(703) 784-1579
(703) 784-1592
Mailing address
QUANTICO NMC ATTN: THIRD PARTY BILLING, 3259 CATLIN AVE, QUANTICO, VA 22134
(703) 784-1579
(703) 784-1592
Taxonomy
Speciality
Code
Description
License number
State
332000000X
Military/U.S. Coast Guard Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2105196
PK
—
Enumeration date
09/22/2006
Last updated
08/25/2015
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