Provider Demographics
NPI:1265845036
Name:MILITARY TREATMENT FACILITY
Entity Type:Organization
Organization Name:MILITARY TREATMENT FACILITY
Other - Org Name:DOD BUCKLEY PHARMACY
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:MILITARY TREATMENT FACILITY C/O MRS. ORA DEE CARTWRIGHT
Mailing Address - Street 2:275 S. ASPEN ST. STOP 89
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80011-9562
Mailing Address - Country:US
Mailing Address - Phone:720-847-6049
Mailing Address - Fax:720-847-7463
Practice Address - Street 1:317 N TELLURIDE ST
Practice Address - Street 2:
Practice Address - City:BUCKLEY AFB
Practice Address - State:CO
Practice Address - Zip Code:80011-7809
Practice Address - Country:US
Practice Address - Phone:720-847-6049
Practice Address - Fax:720-847-5289
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-09
Last Update Date:2024-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332000000XSuppliersMilitary/U.S. Coast Guard Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2145979OtherPK