Organization
DUNHAM ARMY HEALTH CLINIC
Active
Other names
DETRICK PHCY
Organization subpart
No
Provider details
NPI number
Authorized official
HECTOR MORALES (CHIEF DHA PASS)
(210) 536-6650
Entity
Organization
Contact information
Practice address
1452 PORTER ST, FT DETRICK, MD 21702
(301) 619-2850
(301) 619-7676
Mailing address
1452 PORTER ST, 2480 LLEWELLYN AVE STE 5800, FT DETRICK, MD 21702
(301) 619-2850
(301) 619-7676
Taxonomy
Speciality
Code
Description
License number
State
332000000X
Military/U.S. Coast Guard Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2037183
PK
—
Enumeration date
09/22/2006
Last updated
06/03/2015
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