Healthcare Provider Details

I. General information

NPI: 1902218423
Provider Name (Legal Business Name): AMC TRIPLER-SHAFTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/02/2014
Last Update Date: 05/29/2025
Certification Date: 05/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 JARRETT WHITE RD TRIPLER ARMY MEDICAL CENTER
TRIPLER AMC HI
96859-5001
US

IV. Provider business mailing address

TRIPLER ARMY MEDICAL CENTER PAD MCHK-PAT-T 1 JARRETT WHITE RD
HONOLULU HI
96859-5001
US

V. Phone/Fax

Practice location:
  • Phone: 808-433-4477
  • Fax: 808-433-9054
Mailing address:
  • Phone: 808-433-4477
  • Fax: 808-433-9054

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332000000X
TaxonomyMilitary/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