| NPI | 1699872440 |
|---|---|
| Doing Business As | ELLSWORTH PHCY 28TH MDG |
| Entity Type | Organization |
| Authorized Contact | HECTOR MORALES Chief Dha Pass 210-536-6650 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332000000X Military/U.S. Coast Guard Pharmacy |
| Additional Taxonomies | 333600000X Pharmacy |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2016-11-18 |