354TH MEDGRP-EIELSON
NPI 1902867229
Clinic/Center - Military/U.S. Coast Guard Outpatient in Eielson Afb, AK

Q: What is 354th Medgrp-Eielson's NPI number?

The NPI number for 354th Medgrp-Eielson is 1902867229. It was assigned to this organization in the NPPES registry on March 28, 2006. The provider is also known as Eielson AFB MTF.

Q: What is 354th Medgrp-Eielson's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Military/U.S. Coast Guard Outpatient, with taxonomy code 261QM1100X.

Active since March 28, 2006

2630 CENTRAL AVE, SUITE 1M07, EIELSON AFB, AK 99702(907) 377-6579 Get Directions Write a Review

NPPES record last updated: June 17, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Jun 17, 2025, Jun 12, 2025 (2 updates tracked since 2025).

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About 354th Medgrp-eielson NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

354TH MEDGRP-EIELSON (NPI 1902867229) is a healthcare organization registered as a military/u.s. coast guard outpatient in Eielson Afb, Alaska and active in the NPI registry since March 2006. The organization lists Jen Lewandowski, Dha Ubo, as its authorized official.

NPPES Registry Identity

NPI1902867229

Entity TypeOrganization

Primary Taxonomy261QM1100X

Legal Business Name354TH MEDGRP-EIELSON

Location Address2630 CENTRAL AVE, SUITE 1M07Eielson Afb, AK 99702-2325

Mailing Address2630 Central Ave, Suite 1m07Eielson Afb, AK 99702-2325 · (907) 377-6579

Phone(907) 377-6579

Organization SubpartYes

Authorized OfficialJen LewandowskiDha Ubo · (703) 817-4030

Enumeration DateMarch 28, 2006

Last NPPES UpdateJune 17, 20252 updates tracked since enumeration

NPPES CertifiedJune 17, 2025

✔ NPI 1902867229 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyClinic/Center · Military/U.S. Coast Guard OutpatientAmbulatory Health Care Facilities

Taxonomy Code261QM1100X

Definition

The Defense Health Program or U.S. Coast Guard funded fixed facilities or distinct parts of a facility, providing outpatient medical and dental services, primarily for Uniformed Services beneficiaries. A fixed facility is a non-temporary, non-deployed facility. It includes mobile specialty units such as Magnetic Resonance Imaging (MRI) units that may furnish services at the fixed facility. It includes, as examples, the institutional portion of outpatient encounters (except Ambulatory Procedure Visits), supplies issued (e.g., glasses, ostomy supplies, crutches), and radiology and laboratory studies. Does not include items issued directly to a patient from an outpatient pharmacy or patient transport.

Also ListedClinic/Center · Military and U.S. Coast Guard Ambulatory ProcedureTaxonomy 261QM1101X

Also ListedMilitary/U.S. Coast Guard PharmacyTaxonomy 332000000X

2630 CENTRAL AVE, Eielson Afb, AK 99702

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Other Names 1

Other NameEielson Afb Mtf

Other Identifiers 1

Other02-02399AK · Ncpdp

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

KELSEY GENE BROOME PHYSICIAN ASSISTANT

Physician Assistant (Medical)