460TH Medical Logistics WHS

Primary specialty

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

Legal business name

460TH MEDICAL LOGISTICS WHS

Doing business as

Buckley Afb Main Phcy

Practice address

317 N Telluride St
BLDG 7
Buckley Afb, CO 80011-7809

Phone

(720) 847-7455

Fax

(303) 677-7465

NPI assigned

Sep 20, 2006

Organization subpart

No

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

• BUCKLEY AFB MAIN PHCY Doing business as

Locations

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1454284800000",
    "number": "1932206786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "460TH MEDICAL GROUP 275 SOUTH ASPEN STREET",
            "address_2": "STOP 89",
            "city": "BUCKLEY AFB",
            "state": "CO",
            "postal_code": "80011",
            "telephone_number": "720-847-7455",
            "fax_number": "303-677-7465"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "317 N TELLURIDE ST",
            "address_2": "BLDG 7",
            "city": "BUCKLEY AFB",
            "state": "CO",
            "postal_code": "800117809",
            "telephone_number": "720-847-7455",
            "fax_number": "303-677-7465"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "460TH MEDICAL LOGISTICS WHS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-20",
        "last_updated": "2016-02-01",
        "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
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2003353",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BUCKLEY AFB MAIN PHCY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• 460TH Medgrp-Buckley
• Kelsey Alayne Ambler, WHNP-BC
• Gabrielle Quirao Aragon, FNP
• Amit Bhardwaj, MD
• Elizabeth Ann Brock, WHNP
• Roger Joel Brogis II, DO

• Military/U.S. Coast Guard Pharmacy in Buckley Afb, CO
• Providers in Buckley Afb, CO by specialty
• Military/U.S. Coast Guard Pharmacy in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2016; 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.