19th Medgrp-Little Rock

NPI #1073591830 in Lr Afb, Arkansas

Provider Information

NPI Number: 1073591830
Entity Type: Organization
Organization Name: 19th Medgrp-Little Rock
Subpart: Yes (part of a larger organization)
Parent Organization: 19TH MEDGRP-LITTLE ROCK
Primary Specialty: Clinic/Center - Military/U.S. Coast Guard Outpatient
Enumeration Date: Jan 3, 2006
Last Updated: Jun 16, 2025

Practice Location

Address: 1090 ARNOLD DR
City: Lr Afb
State: Arkansas
ZIP Code: 72099-4933
Phone: (501) 987-7414

Authorized Official

Name: JEN LEWANDOWSKI
Title: AIR FORCE UBO ANALYST
Phone: (703) 817-4030

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center - Military and U.S. Coast Guard Ambulatory Procedure — Military and U.S. Coast Guard Ambulatory Procedure	261QM1101X
Military/U.S. Coast Guard Pharmacy	332000000X
Clinic/Center - Military/U.S. Coast Guard Outpatient — Military/U.S. Coast Guard Outpatient	261QM1100X	Primary

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