Organization
20TH MEDGRP-SHAW
Active
Parent organization
20TH MEDGRP-SHAW
Other names
DoD SHAW ePhcy
Organization subpart
Yes
Provider details
NPI number
Legal business name
20TH MEDGRP-SHAW
Authorized official
HECTOR MORALES (CHIEF DHA PASS)
(210) 536-6650
Entity
Organization
Contact information
Practice address
431 MEADOWLARK ST, SHAW AFB, SC 29152-5019
(803) 895-1309
(803) 895-6463
Mailing address
20TH MEDICAL SUPPORT SQUADRON US AIR FORCE HOSPITAL, 431 MEADOWLARK ST, SHAW AFB, SC 29152
(803) 895-1309
(803) 895-6463
Taxonomy
Speciality
Code
Description
License number
State
332000000X
Military/U.S. Coast Guard Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2146551
PK
—
Enumeration date
06/26/2014
Last updated
05/30/2025
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