628th Medgrp-Charleston
628th Medgrp-Charleston is a Military/U.S. Coast Guard Outpatient Clinic/Center in Charleston AFB, South Carolina. Registered with an NPI since 2006.
- In the registry since
- 2006
- Specialties on file
- 3
Practice location Address checks out
204 W Hill Blvd Bldg 364Charleston AFB, SC 29404-4704
Phone: (843) 963-6884
Fax: (843) 963-6538
Show map & directions
Directions in Google Maps · Apple Maps · OpenStreetMap
Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Military/U.S. Coast Guard Outpatient Clinic/Center (primary) | Taxonomy 261QM1100X |
|---|---|
| Military and U.S. Coast Guard Ambulatory Procedure Clinic/Center | Taxonomy 261QM1101X |
| Military/U.S. Coast Guard Pharmacy | Taxonomy 332000000X |
Record details
| NPI number | 1114905775 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | Yes |
| Parent organization | 628th Medgrp-Charleston |
| Authorized official | Jen Lewandowski — Dha Ubo · (703) 817-4030 |
| NPI enumerated | January 4, 2006 |
| Last updated in NPPES | June 17, 2025 |
| Certification date | June 17, 2025 |
| Mailing address | 204 W Hill Blvd, Bldg 364, Charleston Afb, SC 29404-4704 |