Organization · Type 2 NPI

28th Medgrp-Ellsworth

Military/U.S. Coast Guard Outpatient Clinic/Center · Ellsworth Afb, SD

NPI number 1023091642 Active

Practice location

2900 Doolittle Dr
Ellsworth Afb, SD 57706-4821

Call (605) 385-3311 Map

Fax (605) 385-3234

Specialties and licenses

TaxonomyCodeLicense
Military/U.S. Coast Guard Outpatient Clinic/Center Primary 261QM1100XNone listed
Military and U.S. Coast Guard Ambulatory Procedure Clinic/Center 261QM1101XNone listed
Military/U.S. Coast Guard Pharmacy 332000000XNone listed

Military/U.S. Coast Guard Outpatient Clinic/Center: The Defense Health Program or U.S. Coast Guard funded "fixed" facilities or distinct parts of a facility, providing outpatient medical and dental services, primarily for Uniformed Services beneficiaries. A "fixed" facility is a non-temporary, non-deployed facility. It includes mobile specialty units such as Magnetic Resonance Imaging (MRI) units that may furnish services at the "fixed" facility. It includes, as exam…

78 other providers at this address

About NPI 1023091642

28th Medgrp-Ellsworth's National Provider Identifier is 1023091642, issued on Nov 29, 2005. The primary taxonomy on file is Military/U.S. Coast Guard Outpatient Clinic/Center (261QM1100X), and the practice location is in Ellsworth Afb, SD. The record was last updated on Jun 17, 2025.