Organization
87TH MEDGRP-JB MCGUIRE-DIX-LAKEHURST
Active
Parent organization
87TH MEDGRP-JB MCGUIRE-DIX-LAKEHURST
Other names
JB McGuire-Dix-Lakehurst MTF
Organization subpart
Yes
Provider details
NPI number
Legal business name
87TH MEDGRP-JB MCGUIRE-DIX-LAKEHURST
Authorized official
JEN LEWANDOWSKI (DHA UBO)
(703) 817-4030
Entity
Organization
Contact information
Practice address
3458 NEELY RD, MDSS SGSBR, MC GUIRE AFB, NJ 08641-5312
(609) 754-9658
(609) 754-9541
Mailing address
3458 NEELY RD, MDSS SGSBR, MC GUIRE AFB, NJ 08641-5312
(609) 754-9658
(609) 754-9541
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
—
31-41847
NCPDP
NJ
Enumeration date
04/25/2006
Last updated
06/17/2025
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