5TH Medgrp-Minot
Organization Active NPI Military/U.S. Coast Guard Pharmacy · Minot Afb, ND
NPI 1801201793 · NPPES record last updated May 29, 2025
Key facts
- NPI
- 1801201793
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Military/U.S. Coast Guard Pharmacy 332000000X
- Legal business name
- 5TH MEDGRP-MINOT
- Practice address
- 194 Missile Ave
Minot Afb, ND 58705-5008 - Phone
- (701) 723-5293
- Fax
- (701) 723-5302
- NPI assigned
- Jun 30, 2014
- Organization subpart
- Yes
- Parent organization (as reported)
- 5TH MEDGRP-MINOT
Authorized official
- Name
- Hector Morales
- Title
- Chief Dha Pass
- Phone
- (210) 536-6650
Corporate family (same tax ID) 1
Practitioners 2
-
Gregory Correale, PHARMACIST
-
Yongke Tan, PHARMD
National Provider Directory
- Tax ID family
- 5TH Medgrp-Minot
- Part of
- 5TH Medgrp-Minot
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Military/U.S. Coast Guard Pharmacy | 332000000X | Yes | ||
| Pharmacy | 333600000X |
Addresses
Primary practice location
194 Missile Ave
Minot Afb, ND 58705-5008
Mailing address
5TH Medical Group
10 Missile Ave.
Minot Afb, ND 58705
Phone (701) 723-5293
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2146569 | Other | PK |
Other names
- DoD MINOT ePhcy
Other providers in Minot Afb, ND
- 5TH Medgrp-Minot
- 5TH Medical Group
- Adewale Ajulo
- Folashade Ajulo
- Kirsten Noel Anders
- Kasumi Anderson
All providers in Minot Afb, ND · Military/U.S. Coast Guard Pharmacy in North Dakota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 29, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.