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NPI 1518366574

NPI 1518366574 : 9TH MEDGRP-BEALE : BEALE AFB, CA

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General NPI Number Information
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    NPI Number           |    1518366574
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    Entity Type          |    Organization 
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    Legal Business Name  |    9TH MEDGRP-BEALE 
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Dates
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    Enumeration Date     |    08/15/2014
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    Last Update Date     |    06/12/2025
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Provider Practice Location Address
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    Address Line         |    15301 WARREN SHINGLE RD 
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    City                 |    BEALE AFB
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    State                |    CA
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    Zip                  |    95903-1907
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    Country              |    US
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    Telephone            |    530-634-2337
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    Fax                  |    530-634-4653
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Provider Business Mailing Address
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    Address Line         |    9TH MEDICAL GROUP 15301 WARREN SHINGLE RD.
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    City                 |    BEALE AFB
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    State                |    CA
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    Zip                  |    95903-1907
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    Country              |    US
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    Telephone            |    530-634-2337
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    Fax                  |    530-634-4653
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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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