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General NPI Number Information
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NPI Number | 1053726992
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Entity Type | Organization
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Legal Business Name | ACH WINN-FT STEWART
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Dates
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Enumeration Date | 06/30/2014
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Last Update Date | 03/14/2025
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Provider Practice Location Address
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Address Line | 1061 HARMON AVE
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City | FORT STEWART
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State | GA
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Zip | 31314-5641
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Country | US
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Telephone | 912-435-6040
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Fax | 912-435-5062
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Provider Business Mailing Address
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Address Line | 1061 HARMON AVE STE ID03 C/O WINN-THIRD PARTY INSURANCE
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City | FORT STEWART
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State | GA
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Zip | 31314-5641
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Country | US
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Telephone | 912-435-6147
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Fax | 912-767-8786
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Authorized Official
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Title or Position | CHIEF DHA PASS
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Name | HECTOR MORALES
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Credential |
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Telephone | 210-536-6650
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332000000X
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Taxonomy Name | Military/U.S. Coast Guard Pharmacy
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License Number |
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License Number State |
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