97th Medgrp-Altus
97th Medgrp-Altus is a healthcare organization registered as Military/U.S. Coast Guard Outpatient Clinic/Center in Altus Afb, OK, holding Type 2 (organization) NPI 1093782880 since 2006. The authorized official on file is Jen Lewandowski, Dha Ubo.
✓ Active NPI ✓ Valid NPI checksum Organization subpart
| NPI | 1093782880 |
|---|---|
| Entity type | Organization (Type 2) |
| Legal business name | 97th Medgrp-Altus |
| Parent organization | 97th Medgrp-Altus |
| Practice address | 301 N 1ST ST, BLDG 46, Altus Afb, OK, 73523 |
| Phone | 5804815400 |
| Fax | 5804815416 |
| Enumeration date | 2006-03-01 |
| Last updated in NPPES | 2025-06-17 |
Authorized official
| Name | Jen Lewandowski |
|---|---|
| Title | Dha Ubo |
| Phone | 7038174030 |
Taxonomy & classification
| Taxonomy code | Specialty | Primary | License | State |
|---|---|---|---|---|
| 261QM1100X | Military/U.S. Coast Guard Outpatient Clinic/Center | Primary | — | — |
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3720225 | Other | OK | NCPDP |
Copy-ready billing details
Provider: 97th Medgrp-Altus NPI: 1093782880 Taxonomy: 261QM1100X (Military/U.S. Coast Guard Outpatient Clinic/Center) Address: 301 N 1ST ST, BLDG 46, Altus Afb, OK, 73523
Providers at this address
| NPI | Name | Type | Specialty | Location |
|---|---|---|---|---|
| 1336246180 | Altus Phcy 97th Mdg | Organization | Military/U.S. Coast Guard Pharmacy | Altus Afb, OK |
| 1780831537 | Marilyn Lai | Individual | Optometrist | Altus Afb, OK |
| 1487883526 | Tiffany Brilinski | Individual | Independent Duty Medical Technicians | Altus Afb, OK |
| 1528393626 | Christina Hong | Individual | Pharmacist | Altus Afb, OK |
| 1306174784 | Nguyen Nguyen | Individual | Pharmacist | Altus Afb, OK |
| 1073824421 | Steven Koehl | Individual | Psychiatry Physician | Altus, OK |
| 1023324241 | Alexandra Hernandez | Individual | Dentist | Altus, OK |
| 1598177370 | 97th Medgrp-Altus | Organization | Military/U.S. Coast Guard Pharmacy | Altus Afb, OK |
Verify this record
Cross-check NPI 1093782880 against the authoritative CMS record: view 97th Medgrp-Altus on the official NPPES registry .
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes — even if the provider moves or changes specialty. Read the full guide or validate an NPI number.
Frequently asked questions
What is a Type 2 NPI?
What type of organization is 97th Medgrp-Altus?
Source: CMS NPPES (public data). Snapshot 2026-07-11. Provider record last updated 2025-06-17.