633D MEDGRP-JB LANGLEY NPI 1609859891

NPI Information

NPI: 1609859891
Provider Name: 633D MEDGRP-JB LANGLEY
Classification: Clinic/Center - 261QM1101X
Specialization: Military and U.S. Coast Guard Ambulatory Procedure
Entity Type: Organization
:
Address: 77 NEALY AVE
LANGLEY AFB, VA
ZIP 23665
Phone: (757) 764-6807

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NPI Details

633D MEDGRP-JB LANGLEY is a military and u.s. coast guard ambulatory procedure clinic center in Langley Afb, VA. The provider is that part of a fixed (non-temporary, non-deployed) DoD or Coast Guard entity furnishing surgical procedures requiring medically supervised recovery. Similar to a civilian ambulatory surgical center. May be in shared resources with a DoD or Coast Guard Clinic or a DoD Hospital. Does not include items issued directly to a patient from an outpatient pharmacy or patient transport. Includes initial take home pharmaceuticals. 633D MEDGRP-JB LANGLEY NPI is 1609859891. The provider is registered as an organization entity type.
The provider .

The provider's business location address is:

77 NEALY AVE
LANGLEY AFB, VA
ZIP 23665-040
Phone: (757) 764-6807
Fax: (757) 764-0821

The provider's authorized official is Jen Lewandowski .
The authorized official title is Dha Financial Manager and has the following contact phone number (703) 817-4030.

The enumeration date for this NPI number is 11/22/2005 and was last updated on 6/17/2025.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QM1101X	Clinic/Center	Military and U.S. Coast Guard Ambulatory Procedure			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	4834722	OTHER	VIRGINIA	NCPDP
2	000686	OTHER	VIRGINIA	BCBS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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