Healthcare Provider Details
I. General information
NPI: 1295149383
Provider Name (Legal Business Name): ACH BASSETT-WAINWRIGHT
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/17/2014
Last Update Date: 06/13/2025
Certification Date: 06/13/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
BASSETT ARMY COMMUNITY HOSPITAL MEDDAC-ALASKA 1060 GAFFNEY RD #7400
FT. WAINWRIGHT AK
99703-7400
US
IV. Provider business mailing address
BASSETT ARMY COMMUNITY HOSPITAL 1060 GAFFNEY RD 7420
FT WAINWRIGHT AK
99703
US
V. Phone/Fax
- Phone: 907-361-5758
- Fax: 907-361-4838
- Phone: 907-361-5758
- Fax: 907-361-4838
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 | |
VII. Legacy identifiers
For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:
| # 1 | |
| Identifier | 2146334 |
| Identifier Type | OTHER |
| Identifier State | |
| Identifier Issuer | PK |
VIII. Authorized Official
Name:
HECTOR
MORALES
Title or Position: CHIEF DHA PASS
Credential:
Phone: 210-536-6650