Active NPI
319TH Medgrp-Grand Forks
Doing business as Dod Grand Forks Pharmacy
- Military/U.S. Coast Guard Pharmacy
- Grand Forks AFB, ND
National Provider Identifier
1104231091
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Military/U.S. Coast Guard Pharmacy
- Legal business name
- 319TH MEDGRP-GRAND FORKS
- Doing business as
- Dod Grand Forks Pharmacy
- Practice address
- 1599 J St
Grand Forks AFB, ND 58205-6306 - Phone
- (701) 747-5382
- Fax
- (701) 747-5384
- NPI assigned
- Jun 30, 2014
- Last updated
- May 29, 2025
- Organization subpart
- Yes
- Parent organization
- 319TH MEDGRP-GRAND FORKS
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Hector Morales
- Title
- Chief Dha Pass
- Phone
- (210) 536-6650
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Military/U.S. Coast Guard Pharmacy | 332000000X | NU | Primary |
Addresses
Primary practice location
1599 J St
Grand Forks AFB, ND 58205-6306
Mailing address
319TH Medical Group
3Rd Party Collections 1599 J. Street
Grand Forks Ab, ND 58205-6306
Phone (701) 747-5382
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2146293 | Other | PK |
Other names 1
- DOD GRAND FORKS PHARMACY
National Provider Directory
National Provider Directory- Tax ID family
- 319TH Medgrp-Grand Forks
- Part of
- 319TH Medgrp-Grand Forks
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Military/U.S. Coast Guard Outpatient Clinic/Center
- Grand Forks AFB, ND
- NPI 1578523924
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1404086400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1748476800000",
"number": "1104231091",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "319TH MEDICAL GROUP",
"address_2": "3RD PARTY COLLECTIONS 1599 J. STREET",
"city": "GRAND FORKS AB",
"state": "ND",
"postal_code": "582056306",
"telephone_number": "701-747-5382",
"fax_number": "701-747-5384"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1599 J ST",
"city": "GRAND FORKS AFB",
"state": "ND",
"postal_code": "582056306",
"telephone_number": "701-747-5382",
"fax_number": "701-747-5384"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "319TH MEDGRP-GRAND FORKS",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "319TH MEDGRP-GRAND FORKS",
"enumeration_date": "2014-06-30",
"last_updated": "2025-05-29",
"certification_date": "2025-05-29",
"status": "A",
"authorized_official_last_name": "MORALES",
"authorized_official_first_name": "HECTOR",
"authorized_official_title_or_position": "CHIEF DHA PASS",
"authorized_official_telephone_number": "210-536-6650"
},
"taxonomies": [
{
"code": "332000000X",
"taxonomy_group": "",
"desc": "Military/U.S. Coast Guard Pharmacy",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PK",
"identifier": "2146293",
"state": null
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "DOD GRAND FORKS PHARMACY",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Grand Forks AFB, ND
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.