Organization
19TH MEDGRP-LITTLE ROCK
Active
Parent organization
19TH MEDGRP-LITTLE ROCK
Other names
DoD LITTLE ROCK ePhcy
Organization subpart
Yes
Provider details
NPI number
Legal business name
19TH MEDGRP-LITTLE ROCK
Authorized official
HECTOR MORALES (CHIEF DHA PASS)
(210) 536-6650
Entity
Organization
Contact information
Practice address
1090 ARNOLD DR, LITTLE ROCK AFB, AR 72099-4933
(501) 987-7446
(501) 987-8786
Mailing address
19TH MDSS SGSR C/O MARTHA BLAND, 1090 ARNOLD DR., LR AFB, AR 72099-4933
(501) 987-7446
(501) 987-7605
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
—
2146756
PK
—
Enumeration date
07/09/2014
Last updated
09/19/2025
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