Organization
354TH MEDGRP-EIELSON
Active
Parent organization
354TH MEDGRP-EIELSON
Other names
Eielson AFB MTF
Organization subpart
Yes
Provider details
NPI number
Legal business name
354TH MEDGRP-EIELSON
Authorized official
JEN LEWANDOWSKI (DHA UBO)
(703) 817-4030
Entity
Organization
Contact information
Practice address
2630 CENTRAL AVE, SUITE 1M07, EIELSON AFB, AK 99702-2325
(907) 377-6579
Mailing address
2630 CENTRAL AVE, SUITE 1M07, EIELSON AFB, AK 99702-2325
(907) 377-6579
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
—
02-02399
NCPDP
AK
Enumeration date
03/28/2006
Last updated
06/17/2025
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