Organization
19TH MEDGRP-LITTLE ROCK
Active
Parent organization
19TH MEDGRP-LITTLE ROCK
Other names
Little Rock AFB MTF
Organization subpart
Yes
Provider details
NPI number
Legal business name
19TH MEDGRP-LITTLE ROCK
Authorized official
JEN LEWANDOWSKI (AIR FORCE UBO ANALYST)
(703) 817-4030
Entity
Organization
Contact information
Practice address
1090 ARNOLD DR, LR AFB, AR 72099-4933
(501) 987-7414
(501) 987-7310
Mailing address
1090 ARNOLD DR, LR AFB, AR 72099-4933
(501) 987-7414
(501) 987-7310
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
—
420846
NCPDP
AR
Enumeration date
01/03/2006
Last updated
06/16/2025
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