NPIMap

Organization Active NPI

Naval Hospital Twentynine Palms

Doing business as Dod China Lake Pharmacy

  • Military/U.S. Coast Guard Pharmacy
  • Ridgecrest, CA
National Provider Identifier
1750778569
Registry record updated Mar 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Military/U.S. Coast Guard PharmacyTaxonomy code 332000000X
Legal business name
NAVAL HOSPITAL TWENTYNINE PALMS
Doing business as
Dod China Lake Pharmacy
Practice address
1 Administration Cir
Stop 1311 BLDG 1403
Ridgecrest, CA 93555-6104
Phone
(760) 939-8001
Fax
(619) 939-2911
NPI assigned
Apr 20, 2015
Organization subpart
Yes
Parent organization
NAVAL HOSPITAL TWENTYNINE PALMSAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 13, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Hector Morales
Title
Chief Dha Posc
Phone
(210) 536-6650

Specialties & licenses 1

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

Addresses

Primary practice location

1 Administration Cir
Stop 1311 BLDG 1403
Ridgecrest, CA 93555-6104

Mailing address

PO Box 788250
Twentynine Palms, CA 92278-8250
Phone (619) 532-8400

Other identifiers 1

IdentifierTypeStateIssuer
2151473OtherPK

Other names 1

  • DOD CHINA LAKE PHARMACY Doing business as

National Provider Directory

National Provider Directory
Tax ID family
NH Twentynine Palms6 organizations share this tax ID, including this one
Part of
NH Twentynine Palms

Other organizations with this tax ID 5

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

Locations

1 Administration Cir
Stop 1311
Ridgecrest, CA 93555
Phone (760) 939-1657

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1429488000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678665600000",
    "number": "1750778569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 788250",
            "city": "TWENTYNINE PALMS",
            "state": "CA",
            "postal_code": "922788250",
            "telephone_number": "619-532-8400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 ADMINISTRATION CIR",
            "address_2": "STOP 1311 BLDG 1403",
            "city": "RIDGECREST",
            "state": "CA",
            "postal_code": "935556104",
            "telephone_number": "760-939-8001",
            "fax_number": "619-939-2911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NAVAL HOSPITAL TWENTYNINE PALMS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NAVAL HOSPITAL TWENTYNINE PALMS",
        "enumeration_date": "2015-04-20",
        "last_updated": "2023-03-13",
        "certification_date": "2023-03-13",
        "status": "A",
        "authorized_official_last_name": "MORALES",
        "authorized_official_first_name": "HECTOR",
        "authorized_official_title_or_position": "CHIEF DHA POSC",
        "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
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2151473",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DOD CHINA LAKE PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Ridgecrest, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2023; 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.