Provider Demographics
NPI:1023330743
Name:ACH IRWIN-RILEY
Entity type:Organization
Organization Name:ACH IRWIN-RILEY
Other - Org Name:<UNAVAIL>
Other - Org Type:
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:BLDG 8072 NORMANDY DRIVE
Mailing Address - Street 2:
Mailing Address - City:FT RILEY
Mailing Address - State:KS
Mailing Address - Zip Code:66442
Mailing Address - Country:US
Mailing Address - Phone:785-240-7979
Mailing Address - Fax:785-240-6337
Practice Address - Street 1:BLDG 8072 NORMANDY DRIVE
Practice Address - Street 2:
Practice Address - City:FT RILEY
Practice Address - State:KS
Practice Address - Zip Code:66442
Practice Address - Country:US
Practice Address - Phone:785-240-7979
Practice Address - Fax:785-240-6337
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ACH IRWIN-RILEY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-02-22
Last Update Date:2025-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332000000XSuppliersMilitary/U.S. Coast Guard Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2123928OtherPK