17Th Medgrp-Goodfellow
LBN: 17Th Medgrp-Goodfellow
17Th Medgrp-Goodfellow is an health care organization with primary practice located at 271 Fort Richardson Ave , Goodfellow Afb TX 76908-4901. The organization recently has 3 registered licenses in different health care specialties including Ambulatory Health Care Facilities / Military/U.S. Coast Guard Outpatient, Ambulatory Health Care Facilities / Military and U.S. Coast Guard Ambulatory Procedure, Suppliers / Military/U.S. Coast Guard Pharmacy. Ambulatory Health Care Facilities / Military/U.S. Coast Guard Outpatient is the primary health care specialty.
17Th Medgrp-Goodfellow can be contacted via phone (325) 654-5974, or through Lewandowski, Jen via phone (703) 817-4030.
Contact Information
Primary practice address
271 Fort Richardson Ave
Goodfellow Afb TX 76908-4901
Phone: (325) 654-5974
Fax: (325) 654-3121
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Ambulatory Health Care Facilities / Military/U.S. Coast Guard Outpatient | 261QM1100X | Texas | |
| Ambulatory Health Care Facilities / Military and U.S. Coast Guard Ambulatory Procedure | 261QM1101X | ||
| Suppliers / Military/U.S. Coast Guard Pharmacy | 332000000X |
Profile Details
| NPI number | 1104805142 |
|---|---|
| LBN Legal business name | 17Th Medgrp-Goodfellow |
| DBA Doing business as | |
| Authorized official | Lewandowski, Jen |
| Entity | Organization |
| Organization subpart 1 | Yes |
| Enumeration date | Jan 10th, 2006 |
| Last updated | Jun 17th, 2025 - about last year |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1104805142 | NPPES |
| Texas | Other | 4596740 | NCPDP |
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