99TH MEDICAL GROUP - MIKE O'CALLAGHAN FEDERAL HOSPITAL NPI 1023117462

NPI Information

99TH MEDICAL GROUP - MIKE O'CALLAGHAN FEDERAL HOSPITAL is a military us coast guard pharmacy in Las Vegas, NV. The provider is a Department of Defense (DoD) or U.S. Coast Guard entity whose primary function is to store, prepare and dispense pharmaceuticals and other associated items to Uniformed Services beneficiaries. These pharmacies may be associated with a DoD or U.S. Coast Guard clinic, DoD Hospital or freestanding. Usually associated with outpatient services. 99TH MEDICAL GROUP - MIKE O'CALLAGHAN FEDERAL HOSPITAL NPI is 1023117462. The provider is registered as an organization entity type.
The provider Is Doing Business As Nellis Bravo Phcy.

The provider's business location address is:

4700 LAS VEGAS BLVD N
BLDG 1300
LAS VEGAS, NV
ZIP 89191-600
Phone: (702) 653-3205
Fax: (702) 653-2106

The provider's authorized official is Hector Morales .
The authorized official title is Chief Dha Pass and has the following contact phone number (210) 536-6650.

The enumeration date for this NPI number is 9/22/2006 and was last updated on 1/11/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

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