NPI 1861804551
316th Medgrp-Malcolm Grow
Practice location
- Address
- 238 Brookley Ave SW 579th Medical Group, Bolling Afb, DC 20032-7704
- Phone
- (202) 404-7742
- Fax
- (202) 404-1216
- Mailing address
- 1060 W Perimeter Rd, Jb Andrews, MD 20762-6602
Authorised official
- Name
- William Michael Condon
- Title
- Dha Financial Manager
- Phone
- (240) 401-3643
Registered specialties
Military/U.S. Coast Guard Pharmacy
Primary
Registry record
- NPI
- 1861804551
- Entity type
- Organization
- NPI issued
- 29 May 2014
- Record last updated
- 12 Mar 2025
Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.