# 1ST SPCL OPS MEDGRP-HURLBURT

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** 1ST SPCL OPS MEDGRP-HURLBURT
- **Other names:** 16th Medical Group
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1568442630
- **Legal business name:** 1ST SPCL OPS MEDGRP-HURLBURT
- **Authorized official:** JEN LEWANDOWSKI (DHA FINANCIAL MANAGER)
- **Authorized official phone:** (703) 817-4030

## Contact information

- **Practice address:** 113 LIELMANIS AVE, HURLBURT FIELD, FL 32544-5613
- **Practice address phone:** (850) 881-2331
- **Mailing address:** 113 LIELMANIS AVE, HURLBURT FIELD, FL 32544-5613
- **Mailing address phone:** (850) 881-2331

## 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:** 01/17/2006
- **Last updated:** 06/12/2025

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 1088788 | NCPDP | FL |