Provider Demographics
NPI:1013014869
Name:WRAMC TREASURY TPCP
Entity Type:Organization
Organization Name:WRAMC TREASURY TPCP
Other - Org Name:WASH DC PENTAGON FLIGHT PHCY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF DHA PASS
Authorized Official - Prefix:
Authorized Official - First Name:HECTOR
Authorized Official - Middle Name:
Authorized Official - Last Name:MORALES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-536-6650
Mailing Address - Street 1:1760 USAF PENTAGON
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20330-0001
Mailing Address - Country:US
Mailing Address - Phone:703-697-1188
Mailing Address - Fax:703-614-1663
Practice Address - Street 1:1760 USAF PENTAGON
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20330-0001
Practice Address - Country:US
Practice Address - Phone:703-697-1188
Practice Address - Fax:703-614-1663
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2016-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332000000XSuppliersMilitary/U.S. Coast Guard Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2005907OtherPK