Provider Demographics
NPI:1487954863
Name:NAVAL HOSPITAL GUAM
Entity type:Organization
Organization Name:NAVAL HOSPITAL GUAM
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DEPUTY DIRECTOR OF PHARMACY OPS
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:PSC 490 BOX 156
Mailing Address - Street 2:FPO AP
Mailing Address - City:SANTA RITA
Mailing Address - State:GU
Mailing Address - Zip Code:96540
Mailing Address - Country:US
Mailing Address - Phone:671-339-3017
Mailing Address - Fax:671-339-5002
Practice Address - Street 1:BLDG # 6 CHAPEL RD
Practice Address - Street 2:
Practice Address - City:SANTA RITA
Practice Address - State:GU
Practice Address - Zip Code:96915
Practice Address - Country:US
Practice Address - Phone:671-339-3017
Practice Address - Fax:671-339-5002
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NAVAL HOSPITAL GUAM
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-11-01
Last Update Date:2010-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332000000XSuppliersMilitary/U.S. Coast Guard Pharmacy