OrganizationActive
27th Special Ops Medgrp-Cannon
NPI 1285606384 · Military/U.S. Coast Guard Outpatient Clinic/Center · Cannon Afb, NM
Provider details
- NPI number
- 1285606384
- Entity type
- Organization
- Primary specialty
- Military/U.S. Coast Guard Outpatient Clinic/CenterAmbulatory Health Care Facilities
- Parent organization
- 27th Special Ops Medgrp-Cannon
- Organization subpart
- Yes
- Authorized official
- Jen Lewandowski, Dha Ubo(703) 817-4030
Specialties & taxonomies
Ambulatory Health Care Facilities
- Military/U.S. Coast Guard Pharmacy332000000X
Suppliers
Ambulatory Health Care Facilities
Practice location
208 W Casablanca Ave
27 Mdss Sgsr
Cannon Afb, NM 88103-5009
Phone: (505) 784-4023
Fax: (505) 784-7749
Approximate (ZIP-level) locationGet directions
Mailing address
208 W Casablanca Ave
Cannon Afb, NM 88103-5009
Registry dates
- Enumerated
- 2006-02-02
- Last updated
- 2025-06-17
- Certified
- 2025-06-17
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.