Provider Demographics
NPI:1194137711
Name:NAVAL HOSPITAL GUAM
Entity type:Organization
Organization Name:NAVAL HOSPITAL GUAM
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF DHA POSC
Authorized Official - Prefix:MR
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:ERMC UNIFORM BUSINESS OFFICE
Mailing Address - Street 2:CDR 402 BLDG 3700 ERMC UBO
Mailing Address - City:AGANA HEIGHTS
Mailing Address - State:GU
Mailing Address - Zip Code:96919-0000
Mailing Address - Country:US
Mailing Address - Phone:671-344-9265
Mailing Address - Fax:671-344-9494
Practice Address - Street 1:US NAVAL HOSPITAL GUAM
Practice Address - Street 2:BLDG. #50, ROOM 1U02
Practice Address - City:AGANA HEIGHTS
Practice Address - State:GU
Practice Address - Zip Code:96919-0000
Practice Address - Country:US
Practice Address - Phone:671-344-9265
Practice Address - Fax:671-344-9494
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NAVAL HOSPITAL GUAM
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-06-02
Last Update Date:2024-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332000000XSuppliersMilitary/U.S. Coast Guard Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2146015OtherPK