366th Medgrp-mountain Home
Military and U.S. Coast Guard Ambulatory Procedure
90 Hope Drive Bldg 6000, 366 Medical Group, Mountain Home Afb
Idaho, 83648-1062
208-828-7470 208-828-2753
366th Medgrp-mountain Home is a Military and U.S. Coast Guard Ambulatory Procedure in Mountain Home Afb, Idaho. This organization is also known as sub part of 366th Medgrp-mountain Home. It is located at 90 Hope Drive Bldg 6000, 366 Medical Group, Mountain Home Afb and it's customer support contact number is 208-828-7470. The authorized person of 366th Medgrp-mountain Home is Jen Lewandowski who is Dha Ubo of the pharmacy and his contact number is 703-817-4030.
366th Medgrp-mountain Home 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.
Pharmacy Details:
366th Medgrp-mountain Home 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: | 366th Medgrp-mountain Home |
| Type: | Military and U.S. Coast Guard Ambulatory Procedure |
| Location: | 90 Hope Drive Bldg 6000, 366 Medical Group, Mountain Home Afb,
Idaho, 83648-1062 |
| Phone: | 208-828-7470 |
| Fax: | 208-828-2753 |
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: | Jen Lewandowski |
| Position: | Dha Ubo |
| Contact Number: | 703-817-4030 |
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: | 1063487791 |
| Parent Organization: | 366th Medgrp-mountain Home |
| NPI Enumeration Date: | 17 Feb, 2006 |
| NPI Last Update On: | 17 Jun, 2025 |
Medical Licenses:
Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for 366th Medgrp-mountain Home are as mentioned below.
| Specialization | License Number | State | Status | |
| Military and U.S. Coast Guard Ambulatory Procedure | | | Primary | |
| Military/U.S. Coast Guard Outpatient | | | 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 |
| 8072078 | Medicaid | Idaho | |
| 1306845 | Other | Idaho | 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: | 90 Hope Drive Bldg 6000, 366 Medical Group Sgsr
Mountain Home Afb, Idaho |
| Zip: | 83648-1062 |
| Phone Number: | 208-828-7470 |
| Fax Number: | 208-828-2753 |
Patients can reach 366th Medgrp-mountain Home at
90 Hope Drive Bldg 6000, 366 Medical Group, Mountain Home Afb, Idaho or can
call on customer care at 208-828-7470.
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**Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 08 December, 2025.