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Organization

22D MEDGRP-MCCONNELL

Active
Parent organization
22D MEDGRP-MCCONNELL
Other names
DoD MCCONNELL ePhcy
Organization subpart
Yes

Provider details

NPI number
Legal business name
22D MEDGRP-MCCONNELL
Authorized official
HECTOR MORALES (CHIEF DHA PASS)
(210) 536-6650
Entity
Organization

Contact information

Practice address
57950 LEAVENWORTH ST BLDG 250, MCCONNELL AFB, KS 67221-3505
(316) 759-5277
(630) 570-6062
Mailing address
22ND MEDICAL GROUP, 57950 LEAVENWORTH ST. 6E4, MCCONNELL AFB, KS 67221-3506
(316) 759-5277
(316) 759-6776

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
2146568
PK
Enumeration date
06/30/2014
Last updated
07/14/2025
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