Healthcare Provider Details

I. General information

NPI: 1134180185
Provider Name (Legal Business Name): 51ST MEDGRP-OSAN
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/29/2006
Last Update Date: 06/12/2025
Certification Date: 06/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

RESOURCE MANAGMENT UNIT 2060
APO AP
96278
KR

IV. Provider business mailing address

RESOURCE MANAGEMENT UNIT 2060
APO AP
96278
KR

V. Phone/Fax

Practice location:
  • Phone: 01182316614194
  • Fax: 01182316614194
Mailing address:
  • Phone: 01182316614194
  • Fax: 01182316614194

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2865M2000X
TaxonomyMilitary General Acute Care Hospital
License Number
License Number State

VIII. Authorized Official

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