Provider Demographics
NPI:1205249059
Name:NMC PORTSMOUTH
Entity type:Organization
Organization Name:NMC PORTSMOUTH
Other - Org Name:<UNAVAIL>
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:THIRD PARTY COLLECTIONS
Mailing Address - Street 2:620 JOHN PAUL JONES CIR
Mailing Address - City:SEWELLS
Mailing Address - State:VA
Mailing Address - Zip Code:23708-2111
Mailing Address - Country:US
Mailing Address - Phone:757-953-8824
Mailing Address - Fax:757-953-9018
Practice Address - Street 1:1647 ADMIRAL TAUSSIG BLVD BLDG CD2
Practice Address - Street 2:
Practice Address - City:SEWELLS
Practice Address - State:VA
Practice Address - Zip Code:23511-2803
Practice Address - Country:US
Practice Address - Phone:757-953-8824
Practice Address - Fax:757-953-9018
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NMC PORTSMOUTH
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-06-10
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
2146183OtherPK