Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

96th Medgrp-Eglin

Organization Military/U.S. Coast Guard Outpatient Clinic/Center · NPI 1588647770

96th Medgrp-Eglin is a Military/U.S. Coast Guard Outpatient Clinic/Center in Eglin AFB, Florida. Registered with an NPI since 2005.

In the registry since
2005
Specialties on file
4

Practice location Address checks out

307 Boatner Rd Ste 114
Eglin AFB, FL 32542-1302
Phone: (850) 883-9015
Fax: (850) 883-8659
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Military General Acute Care Hospital (primary) Taxonomy 2865M2000X
Military/U.S. Coast Guard Outpatient Clinic/Center 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 number1588647770
Entity typeOrganization (Type 2)
Organization subpartYes
Parent organization96th Medgrp-Eglin
Authorized official Jen Lewandowski — Air Force Uniform Business Office · (703) 817-4030
Other names 96th Medical Support Squadron Or 96 Mdss Sgsr
NPI enumeratedNovember 22, 2005
Last updated in NPPESJune 16, 2025
Certification dateJune 16, 2025
Mailing address307 Boatner Rd, Suite 114, Eglin Afb, FL 32542-1302

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