412th Medgrp-edwards

Military/U.S. Coast Guard Outpatient


  
  30 Nightingale Rd, Bldg 5525, Edwards Afb
California, 93524-0001

 661-275-2634    661-277-6645
412th Medgrp-edwards is a Military/U.S. Coast Guard Outpatient in Edwards Afb, California. This organization is also known as sub part of 412th Medgrp-edwards. It is located at 30 Nightingale Rd, Bldg 5525, Edwards Afb and it's customer support contact number is 661-275-2634. The authorized person of 412th Medgrp-edwards is Jen Lewandowski who is Air Force Ubo Analyst of the pharmacy and his contact number is 703-817-4030.
412th Medgrp-edwards 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:
412th Medgrp-edwards 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: 412th Medgrp-edwards
Type: Military/U.S. Coast Guard Outpatient
Location:30 Nightingale Rd, Bldg 5525, Edwards Afb,
California, 93524-0001
Phone:661-275-2634
Fax:661-277-6645
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: Air Force Ubo Analyst
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: 1891765046
Parent Organization: 412th Medgrp-edwards
NPI Enumeration Date: 23 Jan, 2006
NPI Last Update On: 16 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 412th Medgrp-edwards are as mentioned below.
SpecializationLicense NumberStateStatus
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.
IdentifierTypeStateIssuer
05-40345OtherCaliforniaNcpdp
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
Address: 30 Nightingale Rd, Bldg 5525
Edwards Afb, California
Zip: 93524-0001
Phone Number: 661-275-2634
Fax Number: 661-277-6645
Patients can reach 412th Medgrp-edwards at 30 Nightingale Rd, Bldg 5525, Edwards Afb, California or can call on customer care at 661-275-2634.

Comments/ Reviews:


*Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 13 October, 2025.

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