Organization
56TH MEDGRP-LUKE
Active
Parent organization
56TH MEDGRP-LUKE
Other names
Luke AFB MTF
Organization subpart
Yes
Provider details
NPI number
Legal business name
56TH MEDGRP-LUKE
Authorized official
JEN LEWANDOWSKI (AIR FORCE UBO ANALYST)
(703) 817-4030
Entity
Organization
Contact information
Practice address
7219 N LITCHFIELD RD, LUKE AFB, AZ 85309
(623) 856-4057
Mailing address
7219 N LITCHFIELD RD, LUKE AFB, AZ 85309
(623) 856-4057
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
—
0323953
NCPDP
AZ
Enumeration date
12/14/2005
Last updated
06/16/2025
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