Organization
633D MEDGRP-JB LANGLEY
Active
Parent organization
633D MEDGRP-JB LANGLEY
Other names
1st Medical Group
Organization subpart
Yes
Provider details
NPI number
Legal business name
633D MEDGRP-JB LANGLEY
Authorized official
JEN LEWANDOWSKI (DHA FINANCIAL MANAGER)
(703) 817-4030
Entity
Organization
Contact information
Practice address
77 NEALY AVE, LANGLEY AFB, VA 23665-2040
(757) 764-6807
(757) 764-0821
Mailing address
77 NEALY AVE, LANGLEY AFB, VA 23665-2040
(757) 764-6807
(757) 764-0821
Taxonomy
Speciality
Code
Description
License number
State
261QM1101X
Military and U.S. Coast Guard Ambulatory Procedure Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000686
BCBS
VA
01
—
4834722
NCPDP
VA
Enumeration date
11/22/2005
Last updated
06/17/2025
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