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Contact Information

21ST MEDGRP-PETERSON
559 VINCENT ST
PETERSON AFB, CO80914-1541
 Phone: 719-556-1250
 Fax:
 Website:
Indicates primary specialty

NPI Profile & details for 21ST MEDGRP-PETERSON

NPI Number 1942286224
LBN Legal business name 21ST MEDGRP-PETERSON
Authorized official JEN LEWANDOWSKI - (DHA UBO)
Entity Organization
Organization subpart 1 Yes
Enumeration date 12/19/2005
Last updated 06/17/2025 - About 12 months ago
Identifiers
CO Other 06-16788 NCPDP
CO Other 1548369259 NPPES
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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