Uscg Humboldt Bay Pharmacy

Primary specialty

Military/U.S. Coast Guard PharmacyTaxonomy code 332000000X

Legal business name

USCG HUMBOLDT BAY PHARMACY

Practice address

1001 Lycoming Ave
McKinleyville, CA 95519-9308

Phone

(707) 839-6179

Fax

(707) 839-6178

NPI assigned

Jun 23, 2021

Organization subpart

Yes

Parent organization

USCG HUMBOLDT BAY PHARMACYAs reported in NPPES

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

Addresses

Other names 1

• USCG HUMBOLDT BAY PHARMACY Doing business as

Part of

Uscg Humboldt Bay Pharmacy

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1624406400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1624406400000",
    "number": "1144899154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 LYCOMING AVE",
            "city": "MCKINLEYVILLE",
            "state": "CA",
            "postal_code": "955199308",
            "telephone_number": "707-839-6179",
            "fax_number": "707-839-6178"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 LYCOMING AVE",
            "city": "MCKINLEYVILLE",
            "state": "CA",
            "postal_code": "955199308",
            "telephone_number": "707-839-6179",
            "fax_number": "707-839-6178"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "USCG HUMBOLDT BAY PHARMACY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "USCG HUMBOLDT BAY PHARMACY",
        "enumeration_date": "2021-06-23",
        "last_updated": "2021-06-23",
        "certification_date": "2021-06-23",
        "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": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "USCG HUMBOLDT BAY PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• U.S. Coast Guard Group/Air Station Humboldt Bay Clinic
• Bert Vanduzer, PTA
• Julie Villegas, LVN
• Kathleen Vogelsang, FNP
• Tara Arness Vu, M.D.
• Cassaundra Maxine Wages

• Military/U.S. Coast Guard Pharmacy in McKinleyville, CA
• Providers in McKinleyville, CA by specialty
• Military/U.S. Coast Guard Pharmacy in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.