Provider Demographics
NPI:1508963356
Name:CARL R DARNALL ARMY MEDICAL CENTER
Entity Type:Organization
Organization Name:CARL R DARNALL ARMY MEDICAL CENTER
Other - Org Name:COPPERAS COVE FCC 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 1:819 E BUSINESS 190
Mailing Address - Street 2:
Mailing Address - City:COPPERAS COVE
Mailing Address - State:TX
Mailing Address - Zip Code:76522-2259
Mailing Address - Country:US
Mailing Address - Phone:254-288-8801
Mailing Address - Fax:254-286-7171
Practice Address - Street 1:819 E BUSINESS 190
Practice Address - Street 2:
Practice Address - City:COPPERAS COVE
Practice Address - State:TX
Practice Address - Zip Code:76522-2259
Practice Address - Country:US
Practice Address - Phone:254-288-8801
Practice Address - Fax:254-286-7171
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2015-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332000000XSuppliersMilitary/U.S. Coast Guard Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2092817OtherPK