ALTUS PHCY 97TH MDG NPI 1336246180

NPI Information

  • NPI: 1336246180
  • Provider Name: ALTUS PHCY 97TH MDG
  • Classification: Military/U.S. Coast Guard Pharmacy - 332000000X
  • Entity Type: Organization
  • Doing Business As: ALTUS PHCY 97TH MDG
  • Address: 301 N 1ST ST
    ALTUS AFB, OK
    ZIP 73523
  • Phone: (580) 481-5258

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NPI Details

ALTUS PHCY 97TH MDG is a military us coast guard pharmacy in Altus Afb, OK. 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. ALTUS PHCY 97TH MDG NPI is 1336246180. The provider is registered as an organization entity type.
The provider Is Doing Business As Altus Phcy 97th Mdg.

The provider's business location address is:

301 N 1ST ST
ALTUS AFB, OK
ZIP 73523-004
Phone: (580) 481-5258
Fax: (580) 481-7420

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 9/20/2006 and was last updated on 2/27/2017.

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:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1332000000XMilitary/U.S. Coast Guard PharmacyYes
2333600000XPharmacyNo

Other Identifiers

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

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
12074861OTHERPK

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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