375TH MEDGRP-SCOTT NPI 1851373161

NPI Details

375TH MEDGRP-SCOTT is a military/u.s. coast guard outpatient clinic center in Scott Afb, IL. The provider is 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. 375TH MEDGRP-SCOTT NPI is 1851373161. The provider is registered as an organization entity type.

The provider's business location address is:

310 W LOSEY ST
SCOTT AFB, IL
ZIP 62225-250
Phone: (618) 256-7392

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

The enumeration date for this NPI number is 11/14/2005 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: