Provider Demographics
NPI:1538251459
Name:SAN DG SANTEE PHCY
Entity type:Organization
Organization Name:SAN DG SANTEE 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 1:110 TOWN CENTER PKWY
Mailing Address - Street 2:BLDG B
Mailing Address - City:SANTEE
Mailing Address - State:CA
Mailing Address - Zip Code:92701
Mailing Address - Country:US
Mailing Address - Phone:318-443-8528
Mailing Address - Fax:
Practice Address - Street 1:110 TOWN CENTER PKWY
Practice Address - Street 2:BLDG B
Practice Address - City:SANTEE
Practice Address - State:CA
Practice Address - Zip Code:92701
Practice Address - Country:US
Practice Address - Phone:318-443-8528
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332000000XSuppliersMilitary/U.S. Coast Guard Pharmacy