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NPI Code Detail

MEDICARE: 355TH MEDGRP-DAVIS-MONTHAN

MEDICARE: 355TH MEDGRP-DAVIS-MONTHAN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QM1101XMilitary and U.S. Coast Guard Ambulatory Procedure Clinic/Center
2332000000XMilitary/U.S. Coast Guard Pharmacy
3261QM1100XMilitary/U.S. Coast Guard Outpatient Clinic/Center

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
10322103OTHERAZNCPDP

General Provider Information

NPI Number : 1245210384
Entity Type Code : Organization
Provider Name (Legal Business Name) : 355TH MEDGRP-DAVIS-MONTHAN
Provider Business Mailing Address
First Line : 4175 S ALAMO AVE
Second Line :
City : TUCSON
State : AZ
Zip : 85707-6097
Country : US
Telephone Number : 520-228-1506
Fax Number : 520-228-0183
Provider Business Practice Location Address
First Line : 4175 S ALAMO AVE
Second Line :
City : TUCSON
State : AZ
Zip : 85707-6097
Country : US
Telephone Number : 520-228-1506
Fax Number : 520-228-0183
Authorized Official
Title or Position : AIR FORCE UNIFORM BUSINESS OFFICE
Name : JEN LEWANDOWSKI
Credential :
Telephone Number : 703-817-4030
Provider Enumeration Date : 01/17/2006
Last Update Date : 06/16/2025

Similar Medicare Providers

1134110174 — MS. ALTHEA B MILLER
Practice Location Address:
4175 S ALAMO AVE , DAVIS-MONTHAN AFB
TUCSON, AZ
85707-6097
Practice Phone: 520-228-2615
Practice Fax: 520-228-2627
1225012321 — DR. GARY LEE HURWITZ M.D.
Practice Location Address:
4175 S ALAMO AVE
TUCSON, AZ
85707-6097
Practice Phone: 520-228-2719
Practice Fax: 520-228-1549
1952389223 — DR. HOWARD ROBERT ZVEITEL D.O.
Practice Location Address:
4175 S ALAMO AVE , 355TH MEDICAL GROUP
TUCSON, AZ
85707-6097
Practice Phone: 520-228-2810
Practice Fax: 520-228-2541
1063482255 — DR. ALLAN CURTISS BUSHNELL JR. MD, MSPH
Practice Location Address:
4175 S ALAMO AVE , DAVIS-MONTHAN AIR FORCE BASE
TUCSON, AZ
85707-6097
Practice Phone: 520-228-2720
Practice Fax:
1841251733 — KENNETH LEE SANDOCK M.D.
Practice Location Address:
4175 S ALAMO AVE
TUCSON, AZ
85707-6097
Practice Phone: 520-228-2870
Practice Fax:
1104860873 — MS. CINDI A GOLD PT, SCS
Practice Location Address:
4175 S ALAMO AVE
TUCSON, AZ
85707-6097
Practice Phone: 520-228-2886
Practice Fax: 520-228-8155

Directions to “355TH MEDGRP-DAVIS-MONTHAN ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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