Provider Demographics
NPI:1902906969
Name:BALAD PHCY
Entity Type:Organization
Organization Name:BALAD PHCY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER PHARMACY OPERATIONS CENTER
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:210-221-8443
Mailing Address - Street 1:AFTH CAMP ANACONDA SAPPER ST.
Mailing Address - Street 2:
Mailing Address - City:BALAD
Mailing Address - State:IRAQ
Mailing Address - Zip Code:AE
Mailing Address - Country:IQ
Mailing Address - Phone:619-645-0101
Mailing Address - Fax:
Practice Address - Street 1:AFTH CAMP ANACONDA SAPPER ST.
Practice Address - Street 2:
Practice Address - City:BALAD
Practice Address - State:IRAQ
Practice Address - Zip Code:AE
Practice Address - Country:IQ
Practice Address - Phone:619-645-0101
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-22
Last Update Date:2008-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332000000XSuppliersMilitary/U.S. Coast Guard Pharmacy