MEDICARE: ACH EVANS-CARSON

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

General Provider Information

NPI Number	:	1386336428
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ACH EVANS-CARSON

Provider Business Mailing Address
First Line	:	3524 AIRFIELD RD BLDG 9621
Second Line	:
City	:	FORT CARSON
State	:	CO
Zip	:	80913-4701
Country	:	US
Telephone Number	:	719-524-6605
Fax Number	:

Provider Business Practice Location Address
First Line	:	3524 AIRFIELD RD BLDG 9621
Second Line	:
City	:	FORT CARSON
State	:	CO
Zip	:	80913-4701
Country	:	US
Telephone Number	:	719-524-6605
Fax Number	:

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

Provider Enumeration Date	:	05/25/2023
Last Update Date	:	06/13/2025

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Directions to “ACH EVANS-CARSON ” Practice Location

Language	Start Address	Practice Location

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