| NPI | 1891857363 | 
|---|---|
| Doing Business As | NELLIS MOD PHCY | 
| Entity Type | Organization | 
| Authorized Contact | HECTOR MORALES Chief Dha Pass 210-536-6650 | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 332000000X MilitaryU.S. Coast Guard Pharmacy | 
| Additional Taxonomies | 333600000X Pharmacy | 
| Enumeration Date | 2006-12-14 | 
| Last Update Date | 2016-01-11 |