NPIMap

Organization Active NPI

Ft Meade Meddac

  • Military/U.S. Coast Guard Pharmacy
  • Fort Meade, MD
National Provider Identifier
1437563871
Registry record updated May 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Military/U.S. Coast Guard PharmacyTaxonomy code 332000000X
Legal business name
FT MEADE MEDDAC
Practice address
2480 Llewellyn Ave Ste 5800
Kimbrough Ambulatory Care Center
Fort Meade, MD 20755-5129
Phone
(301) 677-8800
Fax
(301) 677-8456
NPI assigned
Jun 13, 2014
Organization subpart
Yes
Parent organization
FT MEADE MEDDACAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 30, 2025

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

Specialty (taxonomy)CodeLicenseStatePrimary
Military/U.S. Coast Guard Pharmacy 332000000X Primary
Pharmacy 333600000X

Addresses

Primary practice location

2480 Llewellyn Ave Ste 5800
Kimbrough Ambulatory Care Center
Fort Meade, MD 20755-5129

Mailing address

Kimbrough Acc Military MTF
Co CDR Usameddac MCXR-BD 2480 Luwellyn Ave Ste 5800
Ft Meade, MD 20755-5129
Phone (301) 677-8800

Other identifiers 1

IdentifierTypeStateIssuer
2146217OtherPK

Other names 2

  • DOD FT MEADE PHARMACY Doing business as
  • DoD FT MEADE ePhcy Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Ft Meade Meddac25 organizations share this tax ID, including this one
Part of
Ft Meade Meddac

Other organizations with this tax ID 24

Organizations that report the same tax identification number in the National Provider Directory.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1402617600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1748563200000",
    "number": "1437563871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "KIMBROUGH ACC MILITARY MTF",
            "address_2": "CO CDR USAMEDDAC MCXR-BD 2480 LUWELLYN AVE STE 5800",
            "city": "FT MEADE",
            "state": "MD",
            "postal_code": "207555129",
            "telephone_number": "301-677-8800",
            "fax_number": "301-677-8456"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2480 LLEWELLYN AVE STE 5800",
            "address_2": "KIMBROUGH AMBULATORY CARE CENTER",
            "city": "FORT MEADE",
            "state": "MD",
            "postal_code": "207555129",
            "telephone_number": "301-677-8800",
            "fax_number": "301-677-8456"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FT MEADE MEDDAC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FT MEADE MEDDAC",
        "enumeration_date": "2014-06-13",
        "last_updated": "2025-05-30",
        "certification_date": "2025-05-30",
        "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": "2146217",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DOD FT MEADE PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "DoD FT MEADE ePhcy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fort Meade, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 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.

Verify at the official NPI Registry.