628th Medgrp-Charleston
NPI #1114905775 in Charleston Afb, South Carolina
Provider Information
- NPI Number
- 1114905775
- Entity Type
- Organization
- Organization Name
- 628th Medgrp-Charleston
- Subpart
- Yes (part of a larger organization)
- Parent Organization
- 628TH MEDGRP-CHARLESTON
- Primary Specialty
- Clinic/Center - Military/U.S. Coast Guard Outpatient
- Enumeration Date
- Jan 4, 2006
- Last Updated
- Jun 17, 2025
Practice Location
- Address
- 204 W HILL BLVD
- Address 2
- BLDG 364
- City
- Charleston Afb
- State
- South Carolina
- ZIP Code
- 29404-4704
- Phone
- (843) 963-6884
Authorized Official
- Name
- JEN LEWANDOWSKI
- Title
- DHA UBO
- Phone
- (703) 817-4030
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Military and U.S. Coast Guard Ambulatory Procedure — Military and U.S. Coast Guard Ambulatory Procedure |
| Military/U.S. Coast Guard Pharmacy |
| Clinic/Center - Military/U.S. Coast Guard Outpatient — Military/U.S. Coast Guard Outpatient |
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