Organization
99TH MEDICAL GROUP - MIKE O'CALLAGHAN FEDERAL HOSPITAL
Active
Parent organization
99TH MEDGRP-NELLIS
Other names
99th MEDGRP-NELLIS, Mike O'Callaghan Military Medical Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
99TH MEDGRP-NELLIS
Authorized official
JEN LEWANDOWSKI (DHA UBO)
(703) 817-4030
Entity
Organization
Contact information
Practice address
4700 LAS VEGAS BLVD N, NELLIS AFB, NV 89191-6600
(702) 653-2273
Mailing address
4700 LAS VEGAS BLVD N, NELLIS AFB, NV 89191-6600
Taxonomy
Speciality
Code
Description
License number
State
261QM1100X
Military/U.S. Coast Guard Outpatient Clinic/Center
—
—
261QM1101X
Military and U.S. Coast Guard Ambulatory Procedure Clinic/Center
—
—
286500000X
Military Hospital
Primary
—
—
332000000X
Military/U.S. Coast Guard Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2975742
NCPDP
NV
Enumeration date
02/07/2006
Last updated
06/24/2025
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