Organization
99TH MEDGRP-NELLIS
Active
Parent organization
99TH MEDGRP-NELLIS
Other names
DoD NELLIS ePhcy
Organization subpart
Yes
Provider details
NPI number
Legal business name
99TH MEDGRP-NELLIS
Authorized official
HECTOR MORALES (CHIEF DHA PASS)
(210) 536-6650
Entity
Organization
Contact information
Practice address
4700 LAS VEGAS BLVD N, NELLIS AFB, NV 89191-6600
(702) 653-2747
(702) 653-2755
Mailing address
MIKE OCALLAGHAN FEDERAL HOSPITAL C/O FRANCES BANTUGAN, 4700 LAS VEGAS BLVD N., NELLIS AFB, NV 89191
(702) 653-2747
(702) 653-2755
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
—
2146757
PK
—
Enumeration date
07/09/2014
Last updated
06/13/2025
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