Organization
375TH MEDGRP-SCOTT
Active
Parent organization
375TH MEDGRP-SCOTT
Organization subpart
Yes
Provider details
NPI number
Legal business name
375TH MEDGRP-SCOTT
Authorized official
JEN LEWANDOWSKI (DHA UBO)
(703) 817-4030
Entity
Organization
Contact information
Practice address
310 W LOSEY ST, SCOTT AFB, IL 62225-5250
(618) 256-7392
Mailing address
310 W LOSEY ST, SCOTT AFB, IL 62225-5250
(618) 256-7392
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
—
—
286500000X
Military Hospital
—
—
Other
Enumeration date
11/14/2005
Last updated
06/17/2025
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