OrganizationActive
316th Medgrp-Malcolm Grow
NPI 1861804551 · Military/U.S. Coast Guard Pharmacy · Bolling Afb, DC
Provider details
- NPI number
- 1861804551
- Entity type
- Organization
- Primary specialty
- Military/U.S. Coast Guard PharmacySuppliers
- Parent organization
- 316th Medgrp-Malcolm Grow
- Authorized official
- William Condon, Dha Financial Manager
Practice location
238 Brookley Ave Sw
579th Medical Group
Bolling Afb, DC 20032-7704
Phone: (202) 404-7742
Fax: (202) 404-1216
Mailing address
1060 W Perimeter Rd
Jb Andrews, MD 20762-6602
Registry dates
- Enumerated
- 2014-05-29
- Last updated
- 2025-03-12
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.