Provider Demographics
NPI:1861807703
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:MCDONALD ARMY HEALTH CENTER
Mailing Address - Street 2:C/O ATTN UBO 579 JEFFERSON AVENUE
Mailing Address - City:FORT EUSTIS
Mailing Address - State:VA
Mailing Address - Zip Code:23604-5567
Mailing Address - Country:US
Mailing Address - Phone:757-314-7900
Mailing Address - Fax:757-314-7764
Practice Address - Street 1:576 JEFFERSON AVE
Practice Address - Street 2:
Practice Address - City:FORT EUSTIS
Practice Address - State:VA
Practice Address - Zip Code:23604-1373
Practice Address - Country:US
Practice Address - Phone:757-314-7900
Practice Address - Fax:757-314-7764
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:AHC MCDONALD-EUSTIS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-06-30
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
2146591OtherPK