Healthcare Provider Details
I. General information
NPI: 1033298278
Provider Name (Legal Business Name): LANDSTUHL REGIONAL MEDCEN
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/06/2006
Last Update Date: 06/13/2025
Certification Date: 06/13/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
NATO HEALTH CLINIC BELGIUM RM 155
APO AE
09724
US
IV. Provider business mailing address
CMR 402 BLDG 3700 ERMC UBO RM 155
APO AE
09180
US
V. Phone/Fax
- Phone: 210-221-8274
- Fax:
- Phone: 210-221-8274
- Fax: 210-295-2567
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 332000000X |
| Taxonomy | Military/U.S. Coast Guard Pharmacy |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
HECTOR
MORALES
Title or Position: CHIEF DHA PASS
Credential:
Phone: 210-536-6650