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Organization

375TH MEDGRP-SCOTT

Active
Parent organization
375TH MEDGRP-SCOTT
Other names
DoD SCOTT ePhcy
Organization subpart
Yes

Provider details

NPI number
Legal business name
375TH MEDGRP-SCOTT
Authorized official
HECTOR MORALES (CHIEF DHA PASS)
(210) 536-6650
Entity
Organization

Contact information

Practice address
310 W LOSEY ST, SCOTT AFB, IL 62225-5250
(618) 256-7335
(618) 256-7133
Mailing address
375TH MEDICAL GROUP SCOTT AFB, 310 W. LOSEY ST., SCOTT AFB, IL 62225-5250
(618) 256-7335
(618) 256-7133

Taxonomy

Speciality
Code
Description
License number
State
332000000X
Military/U.S. Coast Guard Pharmacy
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2146550
PK
Enumeration date
06/26/2014
Last updated
05/29/2025
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