Organization
28TH MEDGRP-ELLSWORTH
Active
Parent organization
28TH MEDGRP-ELLSWORTH
Other names
DoD ELLSWORTH ePhcy
Organization subpart
Yes
Provider details
NPI number
Legal business name
28TH MEDGRP-ELLSWORTH
Authorized official
HECTOR MORALES (CHIEF DHA PASS)
(210) 536-6650
Entity
Organization
Contact information
Practice address
2900 DOOLITTLE DR, ELLSWORTH AFB, SD 57706-4821
(605) 385-3250
(605) 385-3679
Mailing address
28TH MEDICAL GROUP SGSR C/O MS. CURLEY, 2900 DOOLITTLE DR., ELLSWORTH AFB, SD 57706-4821
(605) 385-3250
(605) 385-3679
Taxonomy
Speciality
Code
Description
License number
State
332000000X
Military/U.S. Coast Guard Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2146155
PK
—
Enumeration date
06/09/2014
Last updated
05/29/2025
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