12th Medical Group Randolph
Military/U.S. Coast Guard Outpatient
221 3rd St W, Bldg 1040, Randolph A F B
Texas, 78150-4800
210-652-2420 210-652-6571
12th Medical Group Randolph is a Military/U.S. Coast Guard Outpatient in Randolph A F B, Texas. It is located at 221 3rd St W, Bldg 1040, Randolph A F B and it's customer support contact number is 210-652-2420. The authorized person of 12th Medical Group Randolph is Serena Lynn Hansken who is Air Force Uniform Business Office of the pharmacy and his contact number is 703-588-6419.
12th Medical Group Randolph 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.
Pharmacy Details:
12th Medical Group Randolph type, location, contact phone number and fax are as below. Patients can directly walkin to the pharmacy or can call on the below given customer support phone number for enquiries.
| Name: | 12th Medical Group Randolph |
| Type: | Military/U.S. Coast Guard Outpatient |
| Location: | 221 3rd St W, Bldg 1040, Randolph A F B,
Texas, 78150-4800 |
| Phone: | 210-652-2420 |
| Fax: | 210-652-6571 |
Authorized/Official Person Profile:
Officially authorized person to contact for any management issues or complaints of this pharmacy is as below. Person's position and contact details are also mentioned below.
| Name: | Serena Lynn Hansken |
| Position: | Air Force Uniform Business Office |
| Contact Number: | 703-588-6419 |
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details of given pharmacy are as mentioned below.
| NPI Number: | 1316911597 |
| NPI Enumeration Date: | 15 Feb, 2006 |
| NPI Last Update On: | 15 Nov, 2010 |
Medical Licenses:
Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for 12th Medical Group Randolph are as mentioned below.
| Specialization | License Number | State | Status | |
| Military/U.S. Coast Guard Outpatient | | | Primary | |
| Military and U.S. Coast Guard Ambulatory Procedure | | | Secondary | |
| Military/u.s. Coast Guard Pharmacy | | | Secondary | |
Other Medical Identifiers:
Other legacy medical identifiers of the pharmacy such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned as below.
| Identifier | Type | State | Issuer |
| 4512908 | Other | Texas | Ncpdp |
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
| Address: | 221 3rd St W, Bldg 1040
Randolph A F B, Texas |
| Zip: | 78150-4800 |
| Phone Number: | 210-652-2420 |
| Fax Number: | 210-652-6571 |
Patients can reach 12th Medical Group Randolph at
221 3rd St W, Bldg 1040, Randolph A F B, Texas or can
call on customer care at 210-652-2420.
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**Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 08 December, 2025.