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General NPI Number Information
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NPI Number | 1558549121
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Entity Type | Organization
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Legal Business Name | AHC LYSTER-RUCKER
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Dates
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Enumeration Date | 02/06/2008
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Last Update Date | 06/24/2025
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Provider Practice Location Address
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Address Line | 5TH AVE BLDG 4405
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City | FT. RUCKER
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State | AL
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Zip | 36362-5333
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Country | US
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Telephone | 334-255-7178
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Fax |
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Provider Business Mailing Address
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Address Line | 301 ANDREWS RD ATTN MCXY-RM-TPCP
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City | FORT RUCKER
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State | AL
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Zip | 36362
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Country | US
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Telephone | 334-255-7244
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Fax |
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Authorized Official
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Title or Position | MANAGER DOD PHARMACY OPS CENTER
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Name | MR. HECTOR MORALES
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Credential |
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Telephone | 210-221-8274
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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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