# 14TH MEDGRP-COLUMBUS

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** 14TH MEDGRP-COLUMBUS
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1487630356
- **Legal business name:** 14TH MEDGRP-COLUMBUS
- **Authorized official:** JEN LEWANDOWSKI (DHA UBO)
- **Authorized official phone:** (703) 817-4030

## Contact information

- **Practice address:** 201 INDEPENDENCE, SUITE 101, COLUMBUS, MS 39710-5300
- **Practice address phone:** (662) 434-2159
- **Practice address fax:** (662) 434-2242
- **Mailing address:** 201 INDEPENDENCE, SUITE 101, COLUMBUS, MS 39710-5300

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM1100X | Military/U.S. Coast Guard Outpatient Clinic/Center | — | — | Yes |
| 261QM1101X | Military and U.S. Coast Guard Ambulatory Procedure Clinic/Center | — | — | — |
| 332000000X | Military/U.S. Coast Guard Pharmacy | — | — | — |

## Other

- **Enumeration date:** 12/21/2005
- **Last updated:** 06/17/2025

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 2520179 | NCPDP | MS |