National Provider Identifier Database

355TH MEDGRP DAVIS MONTHAN
Military/U.S. Coast Guard Outpatient

The Defense Health Program or U.S. Coast Guard funded ?fixed? facilities or distinct parts of a facility, providing outpatient medical and dental services, primarily for Uniformed Services beneficiaries. A ?fixed? facility is a non-temporary, non-deployed facility. It includes mobile specialty units such as Magnetic Resonance Imaging (MRI) units that may furnish services at the ?fixed? facility. It includes, as examples, the institutional portion of outpatient encounters (except Ambulatory Procedure Visits), supplies issued (e.g., glasses, ostomy supplies, crutches), and radiology and laboratory studies. Does not include items issued directly to a patient from an outpatient pharmacy or patient transport.


Contact Information

355TH MEDGRP-DAVIS-MONTHAN
4175 S ALAMO AVE
TUCSON, AZ85707-6097
Phone: 520-228-1506
Fax: 520-228-0183
Website:
Specialty Taxonomy Code
* Military/U.S. Coast Guard Outpatient 261QM1100X
Military and U.S. Coast Guard Ambulatory Procedure 261QM1101X
Military/U.S. Coast Guard Pharmacy 332000000X

* Indicates primary specialty

NPI Profile & details for 355TH MEDGRP-DAVIS-MONTHAN

NPI Number 1245210384
Legal business name
LBN
355TH MEDGRP-DAVIS-MONTHAN
Authorized official JEN LEWANDOWSKI - (AIR FORCE UNIFORM BUSINESS OFFICE)
Entity Organization
Organization subpart Yes
Enumeration date 01/17/2006
Last updated 06/16/2025 - About 12 months ago
Sole proprietor1 Not specified
Identifiers
  • AZ Other: 0322103 NCPDP

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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