Organization
81ST MEDGRP-KEESLER
Active
Parent organization
81ST MEDGRP-KEESLER
Organization subpart
Yes
Provider details
NPI number
Legal business name
81ST MEDGRP-KEESLER
Authorized official
JEN LEWANDOWSKI (DHA UBO)
(703) 817-4030
Entity
Organization
Contact information
Practice address
301 FISHER ST, STE 101 RM 1A132, KEESLER AFB, MS 39534-2508
(228) 377-4526
(228) 377-4559
Mailing address
301 FISHER ST, STE 101 RM 1A132, KEESLER AFB, MS 39534-2508
(228) 377-4526
(228) 377-4559
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
—
2518338
NCPDP
MS
Enumeration date
01/18/2006
Last updated
06/17/2025
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