Organization
MT HOME REFILL PHCY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HECTOR MORALES (PHARMACY OPERATIONS CENTER MGR)
(210) 221-8443
Entity
Organization
Contact information
Practice address
90 HOPE DR, MOUNTAIN HOME AFB, ID 83648
(208) 828-7480
(208) 828-3785
Mailing address
90 HOPE DR, MOUNTAIN HOME AFB, ID 83648
(208) 828-7480
(208) 828-3785
Taxonomy
Speciality
Code
Description
License number
State
332000000X
Military/U.S. Coast Guard Pharmacy
Primary
—
—
Other
Enumeration date
12/18/2006
Last updated
08/25/2008
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