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Organization
55TH MEDGRP-OFFUTT
Active
Organization
55TH MEDGRP-OFFUTT
Active
Parent organization
55TH MEDGRP-OFFUTT
Other names
55th Medical Group
Organization subpart
Yes
Provider details
NPI number
Legal business name
55TH MEDGRP-OFFUTT
Authorized official
JEN LEWANDOWSKI (DEFENSE HEALTH AGENCY (DHA) FINANCI)
(703) 817-4030
Entity
Organization
Contact information
Practice address
2501 CAPEHART RD, STE 105, OFFUTT A F B, NE 68113-1043
(402) 294-9215
(402) 294-7463
Mailing address
2501 CAPEHART RD, STE 105, OFFUTT A F B, NE 68113-1043
(402) 294-9215
(402) 294-7463
Taxonomy
Speciality
Code
Description
License number
State
261QM1100X
Military/U.S. Coast Guard Outpatient Clinic/Center
—
—
261QM1101X
Military and U.S. Coast Guard Ambulatory Procedure Clinic/Center
—
—
286500000X
Military Hospital
Primary
—
—
332000000X
Military/U.S. Coast Guard Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2815706
NCPDP
NE
Enumeration date
02/06/2006
Last updated
06/17/2025
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