Provider Demographics
NPI:1215006499
Name:ST MAWGAN PHCY
Entity Type:Organization
Organization Name:ST MAWGAN PHCY
Other - Org Name:
Other - Org Type:
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:210-221-8443
Mailing Address - Street 1:PSC 804 BOX 6
Mailing Address - Street 2:
Mailing Address - City:CORNWALL
Mailing Address - State:ENGLAND
Mailing Address - Zip Code:AE
Mailing Address - Country:GB
Mailing Address - Phone:01144163-787-6111
Mailing Address - Fax:
Practice Address - Street 1:PSC 804 BOX 6
Practice Address - Street 2:
Practice Address - City:CORNWALL
Practice Address - State:ENGLAND
Practice Address - Zip Code:AE
Practice Address - Country:GB
Practice Address - Phone:01144163-787-6111
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-06
Last Update Date:2008-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332000000XSuppliersMilitary/U.S. Coast Guard Pharmacy