Organization
AHC LYSTER-RUCKER
Active
Parent organization
AHC LYSTER-RUCKER
Other names
DOD FT NOVOSEL PHARMACY
Organization subpart
Yes
Provider details
NPI number
Legal business name
AHC LYSTER-RUCKER
Authorized official
HECTOR MORALES (CHIEF DHA PASS)
(210) 536-6650
Entity
Organization
Contact information
Practice address
301 ANDREWS AVENUE, FORT NOVOSEL, AL 36362-5350
(334) 225-7181
(334) 225-7176
Mailing address
UNITED STATES ARMY AREOMEDICAL CENTER, 301 ANDREWS AVENUE C/O ATTN MCXY-RM-TPCP, FT NOVOSEL, AL 36362
(334) 225-7181
(334) 225-7176
Taxonomy
Speciality
Code
Description
License number
State
332000000X
Military/U.S. Coast Guard Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2146669
PK
—
Enumeration date
07/07/2014
Last updated
06/24/2025
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