Organization
377TH MEDGRP-KIRTLAND
Active
Parent organization
377TH MEDGRP-KIRTLAND
Other names
DOD KIRTLAND PHARMACY
Organization subpart
Yes
Provider details
NPI number
Legal business name
377TH MEDGRP-KIRTLAND
Authorized official
HECTOR MORALES (CHIEF DHA PASS)
(210) 536-6650
Entity
Organization
Contact information
Practice address
1501 SAN PEDRO DR SE BLDG 47, ALBUQUERQUE, NM 87108-5153
(505) 846-7775
(505) 846-3137
Mailing address
377 TH MEDICAL GROUP, 2050A SECOND ST. SE, KIRTLAND AFB, NM 87117-0001
(505) 846-7775
(505) 846-3137
Taxonomy
Speciality
Code
Description
License number
State
332000000X
Military/U.S. Coast Guard Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2146419
PK
—
Enumeration date
06/19/2014
Last updated
06/13/2025
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