Healthcare Provider Details

I. General information

NPI: 1184030223
Provider Name (Legal Business Name): WALTER REED NATIONAL MILITARY MEDICAL CNTR
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/09/2014
Last Update Date: 05/21/2025
Certification Date: 05/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8901 WISCONSIN AVE BLDG 82
BETHESDA MD
20889-5600
US

IV. Provider business mailing address

4650 TAYLOR RD BOX 509
BETHESDA MD
20889-0001
US

V. Phone/Fax

Practice location:
  • Phone: 301-295-2113
  • Fax: 301-400-3528
Mailing address:
  • Phone: 301-295-2123
  • Fax: 301-400-3528

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332000000X
TaxonomyMilitary/U.S. Coast Guard Pharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State

VIII. Authorized Official

Name: HECTOR MORALES
Title or Position: CHIEF DHA PASS
Credential:
Phone: 210-536-6650