MEDICARE: CARL R DARNALL ARMY MEDICAL CENTER

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	2092824	OTHER		PK

General Provider Information

NPI Number	:	1881793032
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CARL R DARNALL ARMY MEDICAL CENTER

Provider Business Mailing Address
First Line	:	CARL R DARNALL ARMY MEDICAL CENTER
Second Line	:	MCXI-RMD-TP 36000 DARNALL LOOP
City	:	FT HOOD
State	:	TX
Zip	:	76544
Country	:	US
Telephone Number	:	254-288-8801
Fax Number	:	254-286-7171

Provider Business Practice Location Address
First Line	:	BLDG 36000 RM 1538
Second Line	:
City	:	FT HOOD
State	:	TX
Zip	:	76544
Country	:	US
Telephone Number	:	254-288-8801
Fax Number	:	254-286-7171

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

Provider Enumeration Date	:	09/22/2006
Last Update Date	:	06/18/2015

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