Provider Demographics
NPI:1174622542
Name:ACH KELLER-WEST POINT
Entity type:Organization
Organization Name:ACH KELLER-WEST POINT
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:BLDG 606
Mailing Address - Street 2:
Mailing Address - City:WEST POINT
Mailing Address - State:NY
Mailing Address - Zip Code:10996
Mailing Address - Country:US
Mailing Address - Phone:914-938-7800
Mailing Address - Fax:914-938-3168
Practice Address - Street 1:BLDG 606
Practice Address - Street 2:
Practice Address - City:WEST POINT
Practice Address - State:NY
Practice Address - Zip Code:10996
Practice Address - Country:US
Practice Address - Phone:845-938-3003
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ACH KELLER-WEST POINT
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-09-22
Last Update Date:2025-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332000000XSuppliersMilitary/U.S. Coast Guard Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2059056OtherPK
1528161916OtherPARENT BILLING NPI
3308221OtherOTHER ID NUMBER-COMMERCIAL NUMBER