Provider Demographics
NPI:1447434782
Name:WILLIAM BEAUMONT ARMY MEDICAL CENTER
Entity type:Organization
Organization Name:WILLIAM BEAUMONT ARMY MEDICAL CENTER
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF DHA PASS
Authorized Official - Prefix:
Authorized Official - First Name:HECTOR
Authorized Official - Middle Name:
Authorized Official - Last Name:MORALES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-536-6650
Mailing Address - Street 1:WILLIAM BEAUMONT ARMY MEDICAL CTR C/O TREASURERS OFFICE
Mailing Address - Street 2:5005 N PIEDRAS ST
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79920-5001
Mailing Address - Country:US
Mailing Address - Phone:210-221-8274
Mailing Address - Fax:210-221-8131
Practice Address - Street 1:BIGGS ARMY AIRFIELD
Practice Address - Street 2:BLDG 11281
Practice Address - City:FT BLISS
Practice Address - State:TX
Practice Address - Zip Code:79918
Practice Address - Country:US
Practice Address - Phone:915-569-4155
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WILLIAM BEAUMONT ARMY MEDICAL CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-12-21
Last Update Date:2024-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332000000XSuppliersMilitary/U.S. Coast Guard Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2100489OtherPK