Provider Demographics
NPI:1295035673
Name:CARL R DARNALL ARMY MEDICAL CENTER
Entity Type:Organization
Organization Name:CARL R DARNALL ARMY MEDICAL CENTER
Other - Org Name:DOD FT CAVAZOS CBPCC KL 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:CARL R DARNALL ARMY MEDICAL CENTER
Mailing Address - Street 2:MCXI-RMD-TP 36000 DARNALL LOOP
Mailing Address - City:FT CAVAZOS
Mailing Address - State:TX
Mailing Address - Zip Code:76544
Mailing Address - Country:US
Mailing Address - Phone:254-553-6005
Mailing Address - Fax:
Practice Address - Street 1:3404 KAYDENCE CT
Practice Address - Street 2:
Practice Address - City:KILLEEN
Practice Address - State:TX
Practice Address - Zip Code:76542-3338
Practice Address - Country:US
Practice Address - Phone:254-553-6005
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-01
Last Update Date:2023-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332000000XSuppliersMilitary/U.S. Coast Guard Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2127493OtherPK