MEDICARE: ACH MARTIN-BENNING

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
1	332000000X	Military/U.S. Coast Guard Pharmacy

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2128210	OTHER		PK

General Provider Information

NPI Number	:	1992009401
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ACH MARTIN-BENNING

Provider Business Mailing Address
First Line	:	7446 SIGHTSEEING RD RM 119
Second Line	:
City	:	FORT BENNING
State	:	GA
Zip	:	31905-2102
Country	:	US
Telephone Number	:	706-544-1315
Fax Number	:	762-408-8110

Provider Business Practice Location Address
First Line	:	7446 SIGHTSEEING RD
Second Line	:
City	:	FT MOORE
State	:	GA
Zip	:	31905-5431
Country	:	US
Telephone Number	:	706-544-1880
Fax Number	:	706-544-1081

Authorized Official
Title or Position	:	CHIEF DHA PASS
Name	:	HECTOR MORALES
Credential	:
Telephone Number	:	210-536-6650

Provider Enumeration Date	:	12/28/2010
Last Update Date	:	06/30/2025

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Directions to “ACH MARTIN-BENNING ” Practice Location

Language	Start Address	Practice Location

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