Provider Demographics
NPI:1609966936
Name:NAVAL MEDICAL CENTER PORTSMOUTH
Entity Type:Organization
Organization Name:NAVAL MEDICAL CENTER PORTSMOUTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF DHA POSC
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 1:620 JHN PAUL JNS CIR
Mailing Address - Street 2:ATTN MRS. GOODRICH 3RD PARTY COLLECTION
Mailing Address - City:PORTSMOUTH
Mailing Address - State:VA
Mailing Address - Zip Code:23708-2111
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:NAVAL WEAPONS STATION YORKTOWN
Practice Address - Street 2:BLDG 1806
Practice Address - City:YORKTOWN
Practice Address - State:VA
Practice Address - Zip Code:23691-0090
Practice Address - Country:US
Practice Address - Phone:757-953-8402
Practice Address - Fax:757-953-8446
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NAVAL MEDICAL CENTER PORTSMOUTH
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-10-16
Last Update Date:2023-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332000000XSuppliersMilitary/U.S. Coast Guard Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2104773OtherPK