Organization
15TH MEDGRP JBHP-HICKAM
Active
Parent organization
15TH MEDGRP JBHP-HICKAM
Other names
15th Medical Group
Organization subpart
Yes
Provider details
NPI number
Legal business name
15TH MEDGRP JBHP-HICKAM
Authorized official
JEN LEWANDOWSKI (DEFENSE HEALTH AGENCY (DHA) FINANCI)
(703) 817-4030
Entity
Organization
Contact information
Practice address
15TH MEDICAL GROUP SGSBR, 755 SCOTT CIRCLE, HONOLULU, HI 96853-5399
(808) 449-2295
(808) 449-2297
Mailing address
15TH MEDICAL GROUP SGSBR, 755 SCOTT CIRCLE, HONOLULU, HI 96853-5399
(808) 449-2295
(808) 449-2297
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
—
12-03900
NCPDP
HI
01
—
1649379322
NPPES
HI
Enumeration date
02/13/2006
Last updated
06/17/2025
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