Organization
US ARMY HEALTH CLINIC
Active
Parent organization
EVANS ARMY COMMUNITY HOSPITAL
Other names
DUGWAY HC PHCY
Organization subpart
Yes
Provider details
NPI number
Legal business name
EVANS ARMY COMMUNITY HOSPITAL
Authorized official
HECTOR MORALES (MGR PHRMCY OPERATIONS CNTR)
(210) 221-8443
Entity
Organization
Contact information
Practice address
5116 KISTER AVENUE, ROOM #119, DUGWAY, UT 84022
(801) 831-2942
(801) 831-2552
Mailing address
5116 KISTER AVENUE, ATTN MSA OFFICE, DUGWAY, UT 84022
Taxonomy
Speciality
Code
Description
License number
State
332000000X
Military/U.S. Coast Guard Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
005252
NCPDP PAYMENT CENTER
—
01
—
1497702591
FACILITY NPI
—
01
—
1497795702
PARENT FACILITY NPI
—
01
—
4609307
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
09/22/2006
Last updated
03/31/2011
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