Provider Demographics
NPI:1912061664
Name:BG CRAWFORD F SAMS ARMY HEALTH CLINIC
Entity Type:Organization
Organization Name:BG CRAWFORD F SAMS ARMY HEALTH CLINIC
Other - Org Name:CAMP ZAMA OTC PHCY
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:210-221-8443
Mailing Address - Street 1:MSA OFFICE
Mailing Address - Street 2:ATTN MCJA-PA
Mailing Address - City:APO
Mailing Address - State:AP
Mailing Address - Zip Code:96343-5011
Mailing Address - Country:US
Mailing Address - Phone:0118146-407-4693
Mailing Address - Fax:
Practice Address - Street 1:UNIT 45011
Practice Address - Street 2:CAMP ZAMA OTC PHCY
Practice Address - City:APO
Practice Address - State:AP
Practice Address - Zip Code:96338-5011
Practice Address - Country:US
Practice Address - Phone:0118146-407-4475
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BG CRAWFORD F SAMS ARMY HEALTH CLINIC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-12-20
Last Update Date:2012-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332000000XSuppliersMilitary/U.S. Coast Guard Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
8210382OtherNCPDP
1437236817OtherPARENT FACILITY BG CRAWFORD F SAMS ARMY HEALTH CLINIC NPI