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Contact Information

28TH MEDGRP-ELLSWORTH
2900 DOOLITTLE DR
ELLSWORTH AFB, SD57706-4821
 Phone: 605-385-3311
 Fax: 605-385-3234
 Website:
Indicates primary specialty

NPI Profile & details for 28TH MEDGRP-ELLSWORTH

NPI # 1023091642
LBN Legal business name 28TH MEDGRP-ELLSWORTH
Authorized official JEN LEWANDOWSKI - (DHA UBO)
Entity Organization
Organization subpart 1 Yes
Enumeration date 11/29/2005
Last updated 06/17/2025 - About 12 months ago
Identifiers
SD Medicaid 5351000
SD Other 4304969 NCPDP
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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