Altus Phcy 97TH MDG

Primary specialty

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

Legal business name

ALTUS PHCY 97TH MDG

Doing business as

ALTUS PHCY 97TH MDG

Practice address

301 N 1St St
Altus Afb, OK 73523-5004

Phone

(580) 481-5258

Fax

(580) 481-7420

NPI assigned

Sep 20, 2006

Organization subpart

No

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 2

Addresses

Other identifiers 1

Other names 1

• ALTUS PHCY 97TH MDG Doing business as

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Nguyen T Nguyen, PHARMD

  • Pharmacist
  • Altus Afb, OK
  • NPI 1306174784
  NPD (past)
• Julianne Rodgers Shytle, PHARMD

  • Pharmacist
  • Altus, OK
  • NPI 1720817778
  NPD (past)
• Richard Stanley Baker Jr., PHARMD

  • Pharmacist
  • Travis Afb, CA
  • NPI 1912266412
  NPD (past)

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1488153600000",
    "number": "1336246180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 N 1ST ST",
            "city": "ALTUS AFB",
            "state": "OK",
            "postal_code": "735235004",
            "telephone_number": "580-481-5258",
            "fax_number": "580-481-7420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 N 1ST ST",
            "city": "ALTUS AFB",
            "state": "OK",
            "postal_code": "735235004",
            "telephone_number": "580-481-5258",
            "fax_number": "580-481-7420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALTUS PHCY 97TH MDG",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-20",
        "last_updated": "2017-02-27",
        "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
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2074861",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ALTUS PHCY 97TH MDG",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• 97TH Medgrp-Altus
• 97TH Medgrp-Altus
• Tiffany Joyce Brilinski, IDMT
• Christian Aric Carroll
• Sunnye Elizabeth Cope, LCSW
• Katon Rans Harwood, DO
• Christina S Hong

• Military/U.S. Coast Guard Pharmacy in Altus Afb, OK
• Providers in Altus Afb, OK by specialty
• Military/U.S. Coast Guard Pharmacy in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2017; 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.