92D Medgrp-Fairchild

Primary specialty

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

License

910569870 Issued in WA

Legal business name

92D MEDGRP-FAIRCHILD

Doing business as

Dod Fairchild Pharmacy

Practice address

701 Hospital Loop # 135
Fairchild Afb, WA 99011-8704

Phone

(509) 247-5567

NPI assigned

Sep 22, 2006

Organization subpart

Yes

Parent organization

92D MEDGRP-FAIRCHILDAs 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 identifiers 1

Other names 1

• DOD FAIRCHILD PHARMACY Doing business as

Tax ID family

92D Medgrp-Fairchild2 organizations share this tax ID, including this one

Part of

92D Medgrp-Fairchild

Other organizations with this tax ID 1

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

• 92D Medgrp-Fairchild

  • Military/U.S. Coast Guard Outpatient Clinic/Center
  • Fairchild Afb, WA
  • NPI 1104888288
  NPD tax ID

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

{
    "created_epoch": "1158883200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1749772800000",
    "number": "1477652519",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "92ND MEDICAL GROUP",
            "address_2": "RMO OFFICE 3RD PARTY COLLECTIONS 701 HOSPITAL LOOP",
            "city": "FAIRCHILD AFB",
            "state": "WA",
            "postal_code": "990118704",
            "telephone_number": "509-247-5567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 HOSPITAL LOOP # 135",
            "city": "FAIRCHILD AFB",
            "state": "WA",
            "postal_code": "990118704",
            "telephone_number": "509-247-5567"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "92D MEDGRP-FAIRCHILD",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "92D MEDGRP-FAIRCHILD",
        "enumeration_date": "2006-09-22",
        "last_updated": "2025-06-13",
        "certification_date": "2025-06-13",
        "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": "WA",
            "license": "910569870",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2110194",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DOD FAIRCHILD PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• 92D Medgrp-Fairchild
• Elizabeth Andrews, RN, BSN
• Alyssa Lynn Arena, MD
• Katie Beth Austin, PHARMD
• Jason Barkemeyer, PHARMD
• Molly Suzanne Bartleson

• Military/U.S. Coast Guard Pharmacy in Fairchild Afb, WA
• Providers in Fairchild Afb, WA by specialty
• Military/U.S. Coast Guard Pharmacy in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 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.