Provider Demographics
NPI:1134298334
Name:BAVARIA MEDDAC
Entity Type:Organization
Organization Name:BAVARIA MEDDAC
Other - Org Name:WUERZBURG PHCY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER PHARMACY OPERATIONS CENTER
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:210-221-8274
Mailing Address - Street 1:CMR 402
Mailing Address - Street 2:BLDG 3700 ERMC UBO
Mailing Address - City:APO
Mailing Address - State:AE
Mailing Address - Zip Code:09180
Mailing Address - Country:US
Mailing Address - Phone:0114963719-464-7400
Mailing Address - Fax:
Practice Address - Street 1:UNIT 26610
Practice Address - Street 2:WUERZBURG PHCY
Practice Address - City:APO
Practice Address - State:AE
Practice Address - Zip Code:09244
Practice Address - Country:US
Practice Address - Phone:01149931-804-2222
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BAVARIA MEDDAC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-11-06
Last Update Date:2013-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332000000XSuppliersMilitary/U.S. Coast Guard Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
8110253OtherNCPDP
1982778114OtherPARENT FACILITY NPI