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Contact Information

377TH MEDGRP-KIRTLAND
2050A SECOND ST SE
KIRTLAND AFB, NM87117-5524
 Phone: 505-846-3605
 Fax: 505-846-3594
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Military/U.S. Coast Guard Outpatient

261QM1100X
Indicates primary specialty

NPI Profile & details for 377TH MEDGRP-KIRTLAND

NPI # 1912982810
LBN Legal business name 377TH MEDGRP-KIRTLAND
Authorized official JEN LEWANDOWSKI - (DHA UBO)
Entity Organization
Organization subpart 1 Yes
Enumeration date 12/13/2005
Last updated 06/17/2025 - About 12 months ago
Identifiers
NM Other 32-08926 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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