Healthcare Provider Details

I. General information

NPI: 1710392352
Provider Name (Legal Business Name): 341ST MEDGRP-MALMSTROM
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/23/2014
Last Update Date: 06/13/2025
Certification Date: 06/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7300 N PERIMETER RD
MALMSTROM AFB MT
59402-6701
US

IV. Provider business mailing address

341ST MEDICAL GROUP-UNITED STATES AIR FORCE 7300 NORTH PERIMETER ROAD
MALMSTROM AFB MT
59402
US

V. Phone/Fax

Practice location:
  • Phone: 406-731-3095
  • Fax: 406-731-4928
Mailing address:
  • Phone: 406-731-3095
  • Fax: 406-731-4928

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
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