Provider Demographics
NPI:1932208352
Name:CAPE COD USCG PHCY
Entity Type:Organization
Organization Name:CAPE COD USCG PHCY
Other - Org Name:CAPE COD USCG PHCY
Other - Org Type:Doing Business As
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:US COAST GUARD FINANCE CTR
Mailing Address - Street 2:1430 KRISTINA WAY
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23326-0002
Mailing Address - Country:US
Mailing Address - Phone:210-536-6650
Mailing Address - Fax:210-536-6179
Practice Address - Street 1:KAEHLER MEMORIAL MEDICAL CLINIC
Practice Address - Street 2:5201 LEE RD US AIR STATION
Practice Address - City:CAPE COD
Practice Address - State:MA
Practice Address - Zip Code:02542
Practice Address - Country:US
Practice Address - Phone:508-968-6702
Practice Address - Fax:508-968-6620
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-22
Last Update Date:2015-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332000000XSuppliersMilitary/U.S. Coast Guard Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2039156OtherPK