Provider Demographics
NPI:1861477176
Name:48TH MEDGRP-LAKENHEATH
Entity type:Organization
Organization Name:48TH MEDGRP-LAKENHEATH
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DEFENSE HEALTH AGENCY (DHA) FINANCI
Authorized Official - Prefix:
Authorized Official - First Name:JEN
Authorized Official - Middle Name:
Authorized Official - Last Name:LEWANDOWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-817-4030
Mailing Address - Street 1:BOX 230
Mailing Address - Street 2:UNIT 5210
Mailing Address - City:APO
Mailing Address - State:AE
Mailing Address - Zip Code:09464-5210
Mailing Address - Country:US
Mailing Address - Phone:0163-852-8703
Mailing Address - Fax:
Practice Address - Street 1:48TH MEDICAL GRP RAF LAKENHEATH
Practice Address - Street 2:UNIT 5210
Practice Address - City:APO
Practice Address - State:AE
Practice Address - Zip Code:09464-5210
Practice Address - Country:US
Practice Address - Phone:0163-852-8703
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:48TH MEDGRP-LAKENHEATH
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2005-12-09
Last Update Date:2025-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes286500000XHospitalsMilitary Hospital
No332000000XSuppliersMilitary/U.S. Coast Guard Pharmacy