30Th Medgrp-Vandenberg
LBN: 30Th Medgrp-Vandenberg
30Th Medgrp-Vandenberg is an health care organization with primary practice located at 338 S Dakota Ave , Vandenberg Afb CA 93437-6307. 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.
30Th Medgrp-Vandenberg can be contacted via phone (805) 606-3012, or through Lewandowski, Jen via phone (703) 817-4030.
Contact Information
Primary practice address
338 S Dakota Ave
Vandenberg Afb CA 93437-6307
Phone: (805) 606-3012
Fax: (805) 606-4474
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Ambulatory Health Care Facilities / Military/U.S. Coast Guard Outpatient | 261QM1100X | ||
| 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 | 1477536126 |
|---|---|
| LBN Legal business name | 30Th Medgrp-Vandenberg |
| DBA Doing business as | |
| Authorized official | Lewandowski, Jen |
| Entity | Organization |
| Organization subpart 1 | Yes |
| Enumeration date | Nov 28th, 2005 |
| Last updated | Jun 12th, 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 | 1477536126 | NPPES |
| California | Other | 05-49759 | NCPDP |
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