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Organization
23D MEDGRP-MOODY
Active
Organization
23D MEDGRP-MOODY
Active
Parent organization
23D MEDGRP-MOODY
Other names
Moody AFB MTF
Organization subpart
Yes
Provider details
NPI number
Legal business name
23D MEDGRP-MOODY
Authorized official
JEN LEWANDOWSKI (AIR FORCE UBO ANALYST)
(703) 817-4030
Entity
Organization
Contact information
Practice address
3278 MITCHELL BLVD, MOODY AFB, GA 31699-1500
(229) 257-3041
(229) 257-5528
Mailing address
3278 MITCHELL BLVD, MOODY AFB, GA 31699-1500
(229) 257-3041
(229) 257-5528
Taxonomy
Speciality
Code
Description
License number
State
261QM1100X
Military/U.S. Coast Guard Outpatient Clinic/Center
Primary
—
NULL
261QM1101X
Military and U.S. Coast Guard Ambulatory Procedure Clinic/Center
—
NULL
332000000X
Military/U.S. Coast Guard Pharmacy
—
NULL
Other
Enumeration date
03/28/2006
Last updated
06/16/2025
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