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A Department of Defense (DoD) or U.S. Coast Guard entity whose primary function is to store, prepare and dispense pharmaceuticals and other associated items to Uniformed Services beneficiaries. These pharmacies may be associated with a DoD or U.S. Coast Guard clinic, DoD Hospital or freestanding. Usually associated with outpatient services.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Military/U.S. Coast Guard Pharmacy |
332000000X | 87 | All Other Suppliers |
| NPI # | 1205102761 |
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| LBN Legal business name | 92ND MEDICAL GROUP | ||||
| Authorized official | HECTOR MORALES - (CHIEF DHA PASS) | ||||
| Entity | Organization | ||||
| Organization subpart 1 | No | ||||
| Enumeration date | 03/29/2012 | ||||
| Last updated | 06/12/2015 - About 11 years ago | ||||
| Identifiers |
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92ND MEDICAL GROUP
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| 92ND MEDICAL GROUP BLDG 2460 FAIRCHILD AFB, WA |
| BRITA M HANSON 301 N BROADWAY ST ABERDEEN, WA |
| STEPHEN P MONTOURE, CDPT 224 E WISHKAH ST ABERDEEN, WA |
| ALEXA MAHAN 18311 BOTHELL-EVERETT HIGHWAY 98012, BOTHELL, WA, WA |
| JAMIE K MCINTYRE, LMT 410 E NORTH BEND WAY 98045, WA |
| JAVON J WILSON, BT 18311 BOTHELL-EVERETT HIGHWAY 98012, BOTHELL, WA, WA |
92ND MEDICAL GROUP