Organization
HICKAM 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
755 SCOTT CIR, HICKAM AFB, HI 96853-5399
(808) 448-6242
(808) 448-6740
Mailing address
755 SCOTT CIR, HICKAM AFB, HI 96853-5399
Taxonomy
Speciality
Code
Description
License number
State
332000000X
Military/U.S. Coast Guard Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1203900
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
09/21/2006
Last updated
03/26/2009
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