Organization
MADIGAN ARMY MEDICAL CTR
Active
Other names
LEWIS DISCHARGE PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
HECTOR MORALES (CHIEF DHA PASS)
(210) 536-6650
Entity
Organization
Contact information
Practice address
JACKSON AVE BLDG 9040A, TACOMA, WA 98431-0001
(253) 968-2015
(253) 968-3349
Mailing address
JACKSON AVE BLDG 9040A, ATTN MCHJ-CSA-U, TACOMA, WA 98431-0001
(253) 968-2015
(253) 968-3349
Taxonomy
Speciality
Code
Description
License number
State
332000000X
Military/U.S. Coast Guard Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2110970
PK
—
Enumeration date
12/14/2006
Last updated
04/12/2016
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