21ST MEDICAL GROUP

PETERSON AFB, CO
NPI1932514171
Doing Business AsDOD PETERSON SATL EPHCY
Entity TypeOrganization
Authorized ContactHECTOR MORALES
Chief Dha Pass
210-536-6650
Organization Subpart ?No
Primary Taxonomy332000000X MilitaryU.S. Coast Guard Pharmacy
Additional Taxonomies333600000X Pharmacy
Enumeration Date2014-06-26
Last Update Date2016-04-05
Business Address
21ST MEDICAL GROUP
110 W ENT AVE
PETERSON AFB, CO 80914-1595
Phone number: 719-556-0865
Mailing Address
21ST MEDICAL GROUP
21ST MEDICAL GROUP C/O RMO OFFICE 559 VINCENT ST
PETERSON AFB, CO 80914-1541
Phone number: 719-556-0865
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