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General NPI Number Information
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NPI Number | 1184382715
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Entity Type | Organization
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Legal Business Name | ACH MARTIN-BENNING
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Dates
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Enumeration Date | 12/01/2021
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Last Update Date | 06/06/2025
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Provider Practice Location Address
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Address Line | 6998 OLD CUSSETA RD
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City | FORT BENNING
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State | GA
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Zip | 31905-5431
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Country | US
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Telephone | 706-626-1620
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Fax | 706-626-1621
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Provider Business Mailing Address
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Address Line | 6976 OLD CUSSETA RD BUILDING 4202 ROOM 005V
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City | FORT BENNING
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State | GA
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Zip | 31905-5431
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Country | US
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Telephone | 706-686-1620
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Fax | 762-408-8110
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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 | 3336C0002X
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Taxonomy Name | Clinic Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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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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