Provider Demographics
NPI:1134226988
Name:AHC MCDONALD-EUSTIS
Entity type:Organization
Organization Name:AHC MCDONALD-EUSTIS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF DHA PASS
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:210-536-6650
Mailing Address - Street 1:579 JEFFERSON AVE
Mailing Address - Street 2:ATTN: UBO
Mailing Address - City:FT EUSTIS
Mailing Address - State:VA
Mailing Address - Zip Code:23604-1526
Mailing Address - Country:US
Mailing Address - Phone:757-314-7881
Mailing Address - Fax:
Practice Address - Street 1:649 NEW GUINEA RD
Practice Address - Street 2:
Practice Address - City:FT STORY
Practice Address - State:VA
Practice Address - Zip Code:23459
Practice Address - Country:US
Practice Address - Phone:757-422-7822
Practice Address - Fax:757-314-7764
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:AHC MCDONALD-EUSTIS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-09-20
Last Update Date:2025-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332000000XSuppliersMilitary/U.S. Coast Guard Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2104765OtherPK
4834948OtherOTHER ID NUMBER-COMMERCIAL NUMBER
1922199066OtherPARENT FACILITY NPI