NPI 1811094667 · live from the CMS NPI Registry
366th Medical Group Sgsl
MilitaryU.S. Coast Guard Pharmacy in Mountain Home Afb, ID. National Provider Identifier 1811094667, active.
NPI record
| NPI | 1811094667 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | MilitaryU.S. Coast Guard Pharmacy 332000000X |
| Practice location | 90 Hope Dr, Bldg 6000, Mountain Home Afb, ID 83648 |
| Practice phone | 208-828-7480 |
| Enumerated | September 20, 2006 |
| Last updated | February 8, 2016 |
| Authorized official | Hector Morales, Chief Dha Pass |
| Other names | Mt Home Op Phcy |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Pharmacy | 333600000X | — |
| MilitaryU.S. Coast Guard Pharmacy primary | 332000000X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.