Healthcare Provider Details

I. General information

NPI: 1952716896
Provider Name (Legal Business Name): AMC WILLIAM BEAUMONT-FT BLISS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/30/2014
Last Update Date: 06/12/2025
Certification Date: 06/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1363 ABERDEEN ROAD
WHITE SANDS MISSILE RANGE NM
88002-5520
US

IV. Provider business mailing address

WILLIAM BEAUMONT ARMY MEDICAL CENTER C/O TREASURERS OFFICE 5005 N. PIEDRAS ST.
EL PASO TX
79920-5001
US

V. Phone/Fax

Practice location:
  • Phone: 575-674-3564
  • Fax: 575-674-3620
Mailing address:
  • Phone: 575-674-3564
  • Fax: 575-674-3620

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