Healthcare Provider Details

I. General information

NPI: 1194704916
Provider Name (Legal Business Name): 18TH MEDGRP-KADENA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/11/2006
Last Update Date: 06/12/2025
Certification Date: 06/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

UNIT 5142
APO AP
AP
JP

IV. Provider business mailing address

UNIT 5142
APO AP
AP
JP

V. Phone/Fax

Practice location:
  • Phone: 01181611730
  • Fax: 4188
Mailing address:
  • Phone: 01181611730
  • Fax: 4188

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code286500000X
TaxonomyMilitary Hospital
License Number
License Number State

VIII. Authorized Official

Name: JEN LEWANDOWSKI
Title or Position: DHA FINANCIAL MANAGER
Credential:
Phone: 703-817-4030