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.
| 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 |
| 05-40345 | Other | California | 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: | 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.
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**Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 08 December, 2025.