NPI age
19 years
Enumerated 2006-09-20
● Active Type 2 · Organization
366th Medical Group Sgsl
366th Medical Group Sgsl is 1 of 3 military/u.s. coast guard pharmacy organizations in Idaho.
Primary specialty
Military/U.S. Coast Guard Pharmacy
Plus 1 secondary
Practice locations
1
0 secondary on file
Status
Active
No deactivations on record
Authorized official
Morales
Chief Dha Pass
Last NPPES update
2016-02-08
Source: monthly bulk 2026-05
How this organization compares
Across 3 active military/u.s. coast guard pharmacy providers in Idaho.
NPI age
19 years
≈ at median (19 yr)
Practice locations
1
0 secondary on file
Subspecialties
1
In the 66% of peers with subspecialties
NPI lifetime · 2006 → 2026
2006-09Enumerated in NPPES
2006
2026
Where they practice
Primary practice location
90 Hope Dr, Bldg 6000
Mountain Home Afb, ID 836481057
Mailing address
90 Hope Dr, Bldg 6000
Mountain Home Afb, ID 836481057
Authorized official
Hector Morales
Chief Dha Pass
📞 2105366650
Individual providers at this organization
20 individual providers on file at this primary practice address.
- Susanna Castleberry, LCSW Social Worker NPI 1518365618
- Janette Cooke Dietitian, Registered NPI 1497215982
- Chad Crossley, PT, DPT, MS, OCS, AT Physical Therapist NPI 1457517112
- Derek Dutson, D.M.D. Dentist NPI 1548796527
- Zane Elliott, IDMT Military Health Care Provider NPI 1942072145
- Anthony Ewell-Kollmann, DMD Dentist NPI 1952885121
- Jerrold Flyer, MD Surgery NPI 1417944240
- Eric Galindo, IDMT Military Health Care Provider NPI 1932942323
- Jared Getzlaff, MD Military Health Care Provider NPI 1891224473
- Zachery Glickman Military Health Care Provider NPI 1326857137
- Aspen Guthrie, DSC, MPT Physical Therapist NPI 1295999845
- Kristine Hackett, WHNP Nurse Practitioner NPI 1770579328
- Allen Hauser, PHARMD Pharmacist NPI 1982985669
- Kirsty House, IDMT Military Health Care Provider NPI 1053814236
- Ryan Kainrath, IDMT Military Health Care Provider NPI 1528551751
- Krista Kelly, PA-C Physician Assistant NPI 1477134443
- Casey Lynch, WHNP-BC Nurse Practitioner NPI 1124516372
- Thomas Madden Social Worker NPI 1669444220
- Paula Nordstrom, PH.D. Psychologist NPI 1932134350
- Nathan Palmer, M.D. Family Medicine NPI 1184949935
Specialties
-
Military/U.S. Coast Guard Pharmacy PrimaryA Department of Defense (DoD) or U.S. Coast Guard entity whose primary function is to store, prepare and dispense pharmaceuticals and other associated items to Uniformed Services beneficiaries. These pharmacies may be associated with a...
-
PharmacyA facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally...
Identifiers
| Type | Value | Notes |
|---|---|---|
| 01 | 2021727 | PK |
Other names on file (1)
Doing-business-as, former, and alternate names recorded by NPPES.
-
MT HOME OP PHCY
Practice context
Multi-provider organization. 20 individual providers on file at this primary address.
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- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
- Verify the organization is in good standing.Cross-check with the state's business registration and any applicable licensing boards.
- Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.