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Organization

347TH MEDICAL GROUP SGSL

Active
Other names
MOODY PHCY 23RD MDG
Organization subpart
No

Provider details

NPI number
Authorized official
HECTOR MORALES (CHIEF DHA PASS)
(210) 536-6650
Entity
Organization

Contact information

Practice address
3278 MITCHELL BLVD, MOODY AFB, GA 31699-1500
(229) 257-3221
(229) 257-2345
Mailing address
3278 MITCHELL BLVD, MOODY AFB, GA 31699-1500
(229) 257-3221
(229) 257-2345

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
2019332
PK
Enumeration date
09/21/2006
Last updated
02/08/2016
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