OrganizationActive
366th Medical Group Sgsl
NPI 1811094667 · Military/U.S. Coast Guard Pharmacy · Mountain Home Afb, ID
Provider details
- NPI number
- 1811094667
- Entity type
- Organization
- Primary specialty
- Military/U.S. Coast Guard PharmacySuppliers
- Organization subpart
- No
- Authorized official
- Hector Morales, Chief Dha Pass(210) 536-6650
Specialties & taxonomies
Suppliers
- Pharmacy333600000X
Suppliers
Practice location
90 Hope Dr
Bldg 6000
Mountain Home Afb, ID 83648-1057
Phone: (208) 828-7480
Fax: (208) 828-3785
Approximate (ZIP-level) locationGet directions
Mailing address
90 Hope Dr
Mountain Home Afb, ID 83648-1057
Other names (DBA / former)
- Doing business as
- Mt Home Op Phcy
Registry dates
- Enumerated
- 2006-09-20
- Last updated
- 2016-02-08
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.