Provider Demographics
NPI:1841399011
Name:NAVAL HEALTH CLINIC CHARLESTON
Entity Type:Organization
Organization Name:NAVAL HEALTH CLINIC CHARLESTON
Other - Org Name:DOD CHARLESTON NH PHARMACY
Other - Org Type:Doing Business As
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:NAVY HEALTH CLINIC CHARLESTON
Mailing Address - Street 2:110 NNPTC-CIRCLE UBO/TPC
Mailing Address - City:GOOSE CREEK
Mailing Address - State:SC
Mailing Address - Zip Code:29445
Mailing Address - Country:US
Mailing Address - Phone:843-743-7295
Mailing Address - Fax:843-743-7296
Practice Address - Street 1:110 NNPTC CIR
Practice Address - Street 2:
Practice Address - City:GOOSE CREEK
Practice Address - State:SC
Practice Address - Zip Code:29445-6314
Practice Address - Country:US
Practice Address - Phone:843-794-6100
Practice Address - Fax:843-743-7296
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NAVAL HEALTH CLINIC CHARLESTON
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-09-22
Last Update Date:2023-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332000000XSuppliersMilitary/U.S. Coast Guard Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2091722OtherPK