22d Medgrp-Mcconnell
Clinic/Center, MilitaryU.S. Coast Guard Outpatient in Mcconnell Afb, KS. Organization (NPI-2).
NPI number1700846813
StatusActive
Last updated in NPPESJun 17, 2025
Details
- NPI
- 1700846813
- Entity type
- Organization (NPI-2)
- Legal business name
- 22d Medgrp-Mcconnell
- Organization subpart
- Yes
- Enumeration date
- Mar 23, 2006
- Certification date
- Jun 17, 2025
- Last updated
- Jun 17, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 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 | – | – |
Other names
- Mcconnell Afb Mtf (Other Name)
Practice location
57950 Leavenworth St 6e4Mcconnell Afb, KS 67221-3506
Phone 316-759-5000 · Fax 316-759-5038
Mailing address
57950 Leavenworth St 6e4Mcconnell Afb, KS 67221-3506
Phone 316-759-5000 · Fax 316-759-5038
Authorized official
Jen Lewandowski
Dha Ubo
7038174030
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