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Organization
14TH MEDGRP-COLUMBUS
Active
Organization
14TH MEDGRP-COLUMBUS
Active
Parent organization
14TH MEDGRP-COLUMBUS
Organization subpart
Yes
Provider details
NPI number
Legal business name
14TH MEDGRP-COLUMBUS
Authorized official
JEN LEWANDOWSKI (DHA UBO)
(703) 817-4030
Entity
Organization
Contact information
Practice address
201 INDEPENDENCE, SUITE 101, COLUMBUS, MS 39710-5300
(662) 434-2159
(662) 434-2242
Mailing address
201 INDEPENDENCE, SUITE 101, COLUMBUS, MS 39710-5300
Taxonomy
Speciality
Code
Description
License number
State
261QM1100X
Military/U.S. Coast Guard Outpatient Clinic/Center
Primary
—
—
261QM1101X
Military and U.S. Coast Guard Ambulatory Procedure Clinic/Center
—
—
332000000X
Military/U.S. Coast Guard Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2520179
NCPDP
MS
Enumeration date
12/21/2005
Last updated
06/17/2025
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