Healthcare Provider Details

I. General information

NPI: 1811096969
Provider Name (Legal Business Name): WILLIAM BEAUMONT ARMY MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/22/2006
Last Update Date: 11/08/2024
Certification Date: 11/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

BLDG 2496
FT BLISS TX
79916
US

IV. Provider business mailing address

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

V. Phone/Fax

Practice location:
  • Phone: 915-569-2170
  • Fax: 915-569-1556
Mailing address:
  • Phone: 915-569-2170
  • Fax: 915-569-1556

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