# 71ST MEDGRP-VANCE

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** 71ST MEDGRP-VANCE
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1932187838
- **Legal business name:** 71ST MEDGRP-VANCE
- **Authorized official:** JEN LEWANDOWSKI (DEFENSE HEALTH AGENCY (DHA) FINANCI)
- **Authorized official phone:** (703) 817-4030

## Contact information

- **Practice address:** 527 GOTT RD, ENID, OK 73705-5103
- **Practice address phone:** (580) 213-7907
- **Mailing address:** 527 GOTT RD, ENID, OK 73705-5103
- **Mailing address phone:** (580) 213-7907

## Taxonomy

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

## Other

- **Enumeration date:** 01/03/2006
- **Last updated:** 06/17/2025