Organization · NPI-2

14th Medgrp-Columbus

Clinic/Center, MilitaryU.S. Coast Guard Outpatient · Columbus, MS

NPI number1487630356
StatusActive
Last updated in NPPESJun 17, 2025

Details

NPI
1487630356
Entity type
Organization (NPI-2)
Legal business name
14th Medgrp-Columbus
Organization subpart
Yes
Enumeration date
Dec 21, 2005
Certification date
Jun 17, 2025
Last updated
Jun 17, 2025

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
261QM1100X Clinic/Center, MilitaryU.S. Coast Guard Outpatient––Yes
261QM1101X Clinic/Center, Military and U.S. Coast Guard Ambulatory Procedure––
332000000X MilitaryU.S. Coast Guard Pharmacy––

Practice location

201 Independence
Suite 101
Columbus, MS 39710-5300

Phone 662-434-2159 · Fax 662-434-2242

Mailing address

201 Independence
Suite 101
Columbus, MS 39710-5300

Authorized official

Jen Lewandowski
Dha Ubo
7038174030

Is something wrong?

This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.

Other Clinic/Center, MilitaryU.S. Coast Guard Outpatient providers in Columbus, MS