Active NPI
27TH Special Ops Medgrp-Cannon
Doing business as DoD CANNON ePhcy
- Military/U.S. Coast Guard Pharmacy
- Cannon AFB, NM
National Provider Identifier
1417356072
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Military/U.S. Coast Guard Pharmacy
- Legal business name
- 27TH SPECIAL OPS MEDGRP-CANNON
- Doing business as
- DoD CANNON ePhcy
- Practice address
- 224 West D. L. Ingram Blvd
BLDG 1408
Cannon AFB, NM 88103-5103 - Phone
- (575) 784-4912
- Fax
- (575) 784-7494
- NPI assigned
- Aug 20, 2014
- Last updated
- Sep 2, 2025
- Organization subpart
- Yes
- Parent organization
- 27TH SPECIAL OPS MEDGRP-CANNON
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
224 West D. L. Ingram Blvd
BLDG 1408
Cannon AFB, NM 88103-5103
Mailing address
27TH Medical Group SGSL
208 W. D.L. Ingram Blvd. 1St Floor
Cannon AFB, NM 88103
Phone (575) 784-4028
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2147336 | Other | PK |
Other names 1
- DoD CANNON ePhcy
National Provider Directory
National Provider Directory- Tax ID family
- 27TH Special Ops Medgrp-Cannon
- Part of
- 27TH Special Ops Medgrp-Cannon
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
- Cannon AFB, NM
- NPI 1285606384
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1408492800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1756771200000",
"number": "1417356072",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "27TH MEDICAL GROUP SGSL",
"address_2": "208 W. D.L. INGRAM BLVD. 1ST FLOOR",
"city": "CANNON AFB",
"state": "NM",
"postal_code": "88103",
"telephone_number": "575-784-4028",
"fax_number": "575-784-7494"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "224 WEST D. L. INGRAM BLVD",
"address_2": "BLDG 1408",
"city": "CANNON AFB",
"state": "NM",
"postal_code": "881035103",
"telephone_number": "575-784-4912",
"fax_number": "575-784-7494"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "27TH SPECIAL OPS MEDGRP-CANNON",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "27TH SPECIAL OPS MEDGRP-CANNON",
"enumeration_date": "2014-08-20",
"last_updated": "2025-09-02",
"certification_date": "2025-09-02",
"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": "2147336",
"state": null
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "DoD CANNON ePhcy",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Cannon AFB, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 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.