NPI | 1174507420 |
---|---|
Doing Business As | 460TH MEDICAL GROUP |
Entity Type | Organization |
Authorized Contact | JEN LEWANDOWSKI Dha Ubo 703-817-4030 |
Organization Subpart ? | Yes |
Primary Taxonomy | 261QM1100X Clinic/Center, MilitaryU.S. Coast Guard Outpatient |
Additional Taxonomies | 261Q00000X Clinic/Center |
261QM1101X Clinic/Center, Military and U.S. Coast Guard Ambulatory Procedure | |
332000000X MilitaryU.S. Coast Guard Pharmacy | |
Enumeration Date | 2005-11-30 |
Last Update Date | 2025-06-17 |