MEDICARE: AHC MCDONALD-EUSTIS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332000000X	Military/U.S. Coast Guard Pharmacy

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2104765	OTHER		PK

General Provider Information

NPI Number	:	1134226988
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AHC MCDONALD-EUSTIS

Provider Business Mailing Address
First Line	:	579 JEFFERSON AVE
Second Line	:	ATTN: UBO
City	:	FT EUSTIS
State	:	VA
Zip	:	23604-1526
Country	:	US
Telephone Number	:	757-314-7881
Fax Number	:

Provider Business Practice Location Address
First Line	:	649 NEW GUINEA RD
Second Line	:
City	:	FT STORY
State	:	VA
Zip	:	23459
Country	:	US
Telephone Number	:	757-422-7822
Fax Number	:	757-314-7764

Authorized Official
Title or Position	:	CHIEF DHA PASS
Name	:	HECTOR MORALES
Credential	:
Telephone Number	:	210-536-6650

Provider Enumeration Date	:	09/20/2006
Last Update Date	:	05/30/2025

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Directions to “AHC MCDONALD-EUSTIS ” Practice Location

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