Organization
88TH MEDGRP-WRIGHT-PATTERSON
Active
Parent organization
88TH MEDGRP-WRIGHT-PATTERSON
Other names
88th Medical Group
Organization subpart
Yes
Provider details
NPI number
Legal business name
88TH MEDGRP-WRIGHT-PATTERSON
Authorized official
JEN LEWANDOWSKI (DHA UBO)
(703) 817-4030
Entity
Organization
Contact information
Practice address
88 MDSS/SGSRT, 4881 SUGAR MAPLE DRIVE, WRIGHT PATTERSON, OH 45433-5546
(937) 257-0803
(937) 656-2656
Mailing address
88 MDSS/SGSRT, 4881 SUGAR MAPLE DRIVE, WRIGHT PATTERSON, OH 45433-5546
(937) 257-0803
(937) 656-2656
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
—
—
2865M2000X
Military General Acute Care Hospital
Primary
—
OH
332000000X
Military/U.S. Coast Guard Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
36-66851
NCPDP
OH
Enumeration date
07/11/2006
Last updated
06/17/2025
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