Provider Demographics
NPI:1396722955
Name:35TH MEDGRP-MISAWA
Entity type:Organization
Organization Name:35TH MEDGRP-MISAWA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DHA FINANCIAL MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JEN
Authorized Official - Middle Name:
Authorized Official - Last Name:LEWANDOWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-817-4030
Mailing Address - Street 1:35 MDSS SGSR
Mailing Address - Street 2:UNIT 5024 ATTN MEDICAL SERVICE ACCOUNTS
Mailing Address - City:APO
Mailing Address - State:AP
Mailing Address - Zip Code:96319 5024
Mailing Address - Country:US
Mailing Address - Phone:315-226-6250
Mailing Address - Fax:
Practice Address - Street 1:35 MDSS SGSR
Practice Address - Street 2:UNIT 5024 ATTN MEDICAL SERVICE ACCOUNTS
Practice Address - City:APO
Practice Address - State:AP
Practice Address - Zip Code:96319 5024
Practice Address - Country:US
Practice Address - Phone:315-226-6250
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:35TH MEDGRP-MISAWA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2005-12-26
Last Update Date:2025-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes286500000XHospitalsMilitary Hospital