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NPI Code Detail

MEDICARE: AMC MADIGAN-FT LEWIS

MEDICARE: AMC MADIGAN-FT LEWIS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
13336C0002XClinic Pharmacy
2332000000XMilitary/U.S. Coast Guard Pharmacy

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
12109178OTHERPK

General Provider Information

NPI Number : 1700048972
Entity Type Code : Organization
Provider Name (Legal Business Name) : AMC MADIGAN-FT LEWIS
Provider Business Mailing Address
First Line : MADIGAN ARMY MEDICAL CTR
Second Line : 9040A FITZSIMMONS DR
City : TACOMA
State : WA
Zip : 98431-0001
Country : US
Telephone Number : 210-221-8274
Fax Number : 210-221-8131
Provider Business Practice Location Address
First Line : 690 BARNES BLVD
Second Line :
City : JOINT BASE LEWIS MCCHORD
State : WA
Zip : 98438-1303
Country : US
Telephone Number : 253-982-2478
Fax Number :
Authorized Official
Title or Position : CHIEF DHA PASS
Name : HECTOR MORALES
Credential :
Telephone Number : 210-536-6650
Provider Enumeration Date : 06/30/2008
Last Update Date : 06/13/2025

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Directions to “AMC MADIGAN-FT LEWIS ” Practice Location

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