96th Medgrp-Eglin
96th Medgrp-Eglin is a healthcare organization registered as Military/U.S. Coast Guard Pharmacy in Eglin Afb, FL, holding Type 2 (organization) NPI 1083012223 since 2014. The authorized official on file is Hector Morales, Chief Dha Pass.
✓ Active NPI ✓ Valid NPI checksum Organization subpart
| NPI | 1083012223 |
|---|---|
| Entity type | Organization (Type 2) |
| Legal business name | 96th Medgrp-Eglin |
| Other name | <Unavail> |
| Parent organization | 96th Medgrp-Eglin |
| Practice address | 4315 EL SALVADOR WAY, BUILDING 4315, Eglin Afb, FL, 32542 |
| Phone | 8508857554 |
| Fax | 8508859977 |
| Enumeration date | 2014-12-19 |
| Last updated in NPPES | 2025-06-11 |
Authorized official
| Name | Hector Morales |
|---|---|
| Title | Chief Dha Pass |
| Phone | 2105366650 |
Taxonomy & classification
| Taxonomy code | Specialty | Primary | License | State |
|---|---|---|---|---|
| 332000000X | Military/U.S. Coast Guard Pharmacy | Primary | — | — |
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2149365 | Other | — | PK |
Copy-ready billing details
Provider: 96th Medgrp-Eglin NPI: 1083012223 Taxonomy: 332000000X (Military/U.S. Coast Guard Pharmacy) Address: 4315 EL SALVADOR WAY, BUILDING 4315, Eglin Afb, FL, 32542
Providers at this address
| NPI | Name | Type | Specialty | Location |
|---|---|---|---|---|
| 1578859989 | Stephanie Wallgren | Individual | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist | Eglin Afb, FL |
| 1558719948 | Ngoc Kelsch | Individual | Dental Hygienist | Eglin Afb, FL |
| 1780105817 | John Bunyasaranand | Individual | Emergency Medicine Physician | Eglin Afb, FL |
| 1235862012 | Ryan Bradley | Individual | Medical Physician Assistant | Eglin, FL |
| 1457040867 | Mary Parham | Individual | Dental Hygienist | Eglin Afb, FL |
Verify this record
Cross-check NPI 1083012223 against the authoritative CMS record: view 96th Medgrp-Eglin on the official NPPES registry .
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes — even if the provider moves or changes specialty. Read the full guide or validate an NPI number.
Frequently asked questions
What type of organization is 96th Medgrp-Eglin?
What is a Type 2 NPI?
Source: CMS NPPES (public data). Snapshot 2026-07-11. Provider record last updated 2025-06-11.