Healthcare Provider Details
I. General information
NPI: 1831278035
Provider Name (Legal Business Name): SEMBACH PHCY
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/06/2006
Last Update Date: 08/25/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
BLDG 151 86TH GROUP
SEMBACH GERMANY
AE
DE
IV. Provider business mailing address
BLDG 151 86TH GROUP
SEMBACH GERMANY
AE
DE
V. Phone/Fax
- Phone: 01146302677404
- Fax:
- Phone: 01146302677404
- Fax:
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: MANAGER PHARMACY OPERATIONS CENTER
Credential:
Phone: 210-221-8443