Provider Demographics
NPI:1740389923
Name:AHC REYNOLDS-FT SILL
Entity type:Organization
Organization Name:AHC REYNOLDS-FT SILL
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:THOMAS RD BLDG 6043 TMC2
Mailing Address - Street 2:
Mailing Address - City:FT SILL
Mailing Address - State:OK
Mailing Address - Zip Code:73503
Mailing Address - Country:US
Mailing Address - Phone:580-452-3937
Mailing Address - Fax:580-458-2445
Practice Address - Street 1:THOMAS RD BLDG 6043 TMC2
Practice Address - Street 2:
Practice Address - City:FT SILL
Practice Address - State:OK
Practice Address - Zip Code:73503
Practice Address - Country:US
Practice Address - Phone:580-452-3937
Practice Address - Fax:580-458-2445
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:AHC REYNOLDS-FT SILL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-09-22
Last Update Date:2025-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332000000XSuppliersMilitary/U.S. Coast Guard Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2076249OtherPK