Provider Demographics
NPI:1184382715
Name:ACH MARTIN-BENNING
Entity type:Organization
Organization Name:ACH MARTIN-BENNING
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 1:6976 OLD CUSSETA RD
Mailing Address - Street 2:BUILDING 4202 ROOM 005V
Mailing Address - City:FORT BENNING
Mailing Address - State:GA
Mailing Address - Zip Code:31905-5431
Mailing Address - Country:US
Mailing Address - Phone:706-686-1620
Mailing Address - Fax:762-408-8110
Practice Address - Street 1:6998 OLD CUSSETA RD
Practice Address - Street 2:
Practice Address - City:FORT BENNING
Practice Address - State:GA
Practice Address - Zip Code:31905-5431
Practice Address - Country:US
Practice Address - Phone:706-626-1620
Practice Address - Fax:706-626-1621
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ACH MARTIN-BENNING
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-12-01
Last Update Date:2025-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332000000XSuppliersMilitary/U.S. Coast Guard Pharmacy
No3336C0002XSuppliersPharmacyClinic Pharmacy