Provider Demographics
NPI:1730593567
Name:AHC MUNSON-LEAVENWORTH
Entity type:Organization
Organization Name:AHC MUNSON-LEAVENWORTH
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:MUNSON ARMY HEALTH CENTER
Mailing Address - Street 2:550 POPE AVENUE
Mailing Address - City:FORT LEAVENWORTH
Mailing Address - State:KS
Mailing Address - Zip Code:66027-2332
Mailing Address - Country:US
Mailing Address - Phone:913-684-6059
Mailing Address - Fax:913-684-6065
Practice Address - Street 1:550 POPE AVE
Practice Address - Street 2:MUNSON ARMY HEALTH CENTER
Practice Address - City:FORT LEAVENWORTH
Practice Address - State:KS
Practice Address - Zip Code:66027-2332
Practice Address - Country:US
Practice Address - Phone:913-684-6059
Practice Address - Fax:913-684-6430
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:AHC MUNSON-LEAVENWORTH
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-06-19
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
2146409OtherPK