Organization
5TH MEDGRP-MINOT
Active
Parent organization
5TH MEDGRP-MINOT
Other names
DoD MINOT ePhcy
Organization subpart
Yes
Provider details
NPI number
Legal business name
5TH MEDGRP-MINOT
Authorized official
HECTOR MORALES (CHIEF DHA PASS)
(210) 536-6650
Entity
Organization
Contact information
Practice address
194 MISSILE AVE, MINOT AFB, ND 58705-5008
(701) 723-5293
(701) 723-5302
Mailing address
5TH MEDICAL GROUP, 10 MISSILE AVE., MINOT AFB, ND 58705
(701) 723-5293
(701) 723-5302
Taxonomy
Speciality
Code
Description
License number
State
332000000X
Military/U.S. Coast Guard Pharmacy
Primary
—
—
333600000X
Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2146569
PK
—
Enumeration date
06/30/2014
Last updated
05/29/2025
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