Organization
377TH MEDICAL GROUP - KIRTLAND AFB
Active
Other names
KIRTLAND REFILL PHCY
Organization subpart
No
Provider details
NPI number
Authorized official
HECTOR MORALES (CHIEF DHA PASS)
(210) 536-6650
Entity
Organization
Contact information
Practice address
GIBSON BLVD BLDG 20167, ALBUQUERQUE, NM 87108
(505) 846-6204
(505) 846-4267
Mailing address
377 MDSS SGSR, 2050A 2ND ST. SE, KIRTLAND AFB, NM 87117-0001
(505) 846-3605
Taxonomy
Speciality
Code
Description
License number
State
332000000X
Military/U.S. Coast Guard Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2058614
PK
—
Enumeration date
09/22/2006
Last updated
04/01/2024
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