Organization
4TH MEDGRP-SEYMOUR JOHNSON
Active
Parent organization
4TH MEDGRP-SEYMOUR JOHNSON
Organization subpart
Yes
Provider details
NPI number
Legal business name
4TH MEDGRP-SEYMOUR JOHNSON
Authorized official
JEN LEWANDOWSKI (DHA UBO)
(703) 817-4030
Entity
Organization
Contact information
Practice address
2803 MEDICAL CAMPUS DRIVE, SEYMOUR JOHNSON AFB, NC 27531-2310
(919) 722-8257
Mailing address
2803 MEDICAL CAMPUS DRIVE, SEYMOUR JOHNSON AFB, NC 27531
(919) 722-8257
Taxonomy
Speciality
Code
Description
License number
State
261QM1100X
Military/U.S. Coast Guard Outpatient Clinic/Center
Primary
—
NC
261QM1101X
Military and U.S. Coast Guard Ambulatory Procedure Clinic/Center
—
NC
332000000X
Military/U.S. Coast Guard Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3429405
NCPDP
NC
Enumeration date
12/06/2005
Last updated
06/17/2025
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