377TH Medgrp-Kirtland

Primary specialty

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

Legal business name

377TH MEDGRP-KIRTLAND

Doing business as

Dod Kirtland Pharmacy

Practice address

1501 San Pedro Dr SE BLDG 47
Albuquerque, NM 87108-5153

Phone

(505) 846-7775

Fax

(505) 846-3137

NPI assigned

Jun 19, 2014

Last updated

Jun 13, 2025By the provider in NPPES

Organization subpart

Yes

Parent organization

377TH MEDGRP-KIRTLANDAs 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 KIRTLAND PHARMACY Doing business as

Tax ID family

377TH Medgrp-Kirtland2 organizations share this tax ID, including this one

Part of

377TH Medgrp-Kirtland

Other organizations with this tax ID 1

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

• 377TH Medgrp-Kirtland

  • Military/U.S. Coast Guard Outpatient Clinic/Center
  • Kirtland AFB, NM
  • NPI 1912982810
  NPD tax ID

Locations

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

{
    "created_epoch": "1403136000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1749772800000",
    "number": "1740694553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "377 TH MEDICAL GROUP",
            "address_2": "2050A SECOND ST. SE",
            "city": "KIRTLAND AFB",
            "state": "NM",
            "postal_code": "871170001",
            "telephone_number": "505-846-7775",
            "fax_number": "505-846-3137"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 SAN PEDRO DR SE BLDG 47",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871085153",
            "telephone_number": "505-846-7775",
            "fax_number": "505-846-3137"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "377TH MEDGRP-KIRTLAND",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "377TH MEDGRP-KIRTLAND",
        "enumeration_date": "2014-06-19",
        "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": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2146419",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DOD KIRTLAND PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Military/U.S. Coast Guard Pharmacy in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Military/U.S. Coast Guard Pharmacy in New Mexico

• 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.