Organization
354TH MEDGRP-EIELSON
Active
Parent organization
354TH MEDGRP-EIELSON
Other names
DOD EIELSON PHARMACY
Organization subpart
Yes
Provider details
NPI number
Legal business name
354TH MEDGRP-EIELSON
Authorized official
HECTOR MORALES (CHIEF DHA PASS)
(210) 536-6650
Entity
Organization
Contact information
Practice address
2630 CENTRAL AVE STE 1M07, EIELSON AFB, AK 99702-2325
(907) 377-1462
(907) 377-4105
Mailing address
354 MDG, 2630 CENTAL AVE STE 1M07, EIELSON AFB, AK 99702-2325
(907) 377-1462
(907) 377-4105
Taxonomy
Speciality
Code
Description
License number
State
332000000X
Military/U.S. Coast Guard Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2146023
PK
—
Enumeration date
06/02/2014
Last updated
06/12/2025
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