Provider Demographics
NPI:1952463952
Name:WRAMC
Entity Type:Organization
Organization Name:WRAMC
Other - Org Name:WASH DC DTHC RFL PHCY (PENT)
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACY OPERATIONS CENTER MGR
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:210-221-8274
Mailing Address - Street 1:9300 DEWITT LOOP
Mailing Address - Street 2:ATTN FBCH OTPT TPCP
Mailing Address - City:FT BELVOIR
Mailing Address - State:VA
Mailing Address - Zip Code:22060-5285
Mailing Address - Country:US
Mailing Address - Phone:571-231-2856
Mailing Address - Fax:
Practice Address - Street 1:1501 DEFENSE PENTAGON
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20310
Practice Address - Country:US
Practice Address - Phone:210-221-8274
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WRAMC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-12-15
Last Update Date:2013-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332000000XSuppliersMilitary/U.S. Coast Guard Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
1063441905OtherPARENT FACILITY NPI
0904133OtherNCPDP