628th Medgrp-charleston
Military/U.S. Coast Guard Outpatient
204 W Hill Blvd, Bldg 364, Charleston Afb
South Carolina, 29404-4704
843-963-6884 843-963-6538
628th Medgrp-charleston is a Military/U.S. Coast Guard Outpatient in Charleston Afb, South Carolina. This organization is also known as sub part of 628th Medgrp-charleston. It is located at 204 W Hill Blvd, Bldg 364, Charleston Afb and it's customer support contact number is 843-963-6884. The authorized person of 628th Medgrp-charleston is Jen Lewandowski who is Dha Ubo of the pharmacy and his contact number is 703-817-4030.
628th Medgrp-charleston 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:
628th Medgrp-charleston 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: | 628th Medgrp-charleston |
| Type: | Military/U.S. Coast Guard Outpatient |
| Location: | 204 W Hill Blvd, Bldg 364, Charleston Afb,
South Carolina, 29404-4704 |
| Phone: | 843-963-6884 |
| Fax: | 843-963-6538 |
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: | 1114905775 |
| Parent Organization: | 628th Medgrp-charleston |
| NPI Enumeration Date: | 04 Jan, 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 628th Medgrp-charleston 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 |
| 42-22181 | Other | South Carolina | 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: | 204 W Hill Blvd, Bldg 364
Charleston Afb, South Carolina |
| Zip: | 29404-4704 |
| Phone Number: | 843-963-6884 |
| Fax Number: | 843-963-6538 |
Patients can reach 628th Medgrp-charleston at
204 W Hill Blvd, Bldg 364, Charleston Afb, South Carolina or can
call on customer care at 843-963-6884.
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**Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 08 December, 2025.