Healthcare Provider Details
I. General information
NPI: 1174622542
Provider Name (Legal Business Name): ACH KELLER-WEST POINT
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/22/2006
Last Update Date: 05/29/2025
Certification Date: 05/29/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
BLDG 606
WEST POINT NY
10996
US
IV. Provider business mailing address
BLDG 606
WEST POINT NY
10996
US
V. Phone/Fax
- Phone: 845-938-3003
- Fax:
- Phone: 914-938-7800
- Fax: 914-938-3168
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 | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 333600000X |
| Taxonomy | Pharmacy |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
HECTOR
MORALES
Title or Position: CHIEF DHA PASS
Credential:
Phone: 210-536-6650