Organization · Type 2 NPI
20th Medgrp-Shaw
Military/U.S. Coast Guard Outpatient Clinic/Center · Shaw Afb, SC
Practice location
431 Meadowlark St
Shaw Afb, SC 29152-5019
Fax (803) 895-6419
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Military/U.S. Coast Guard Outpatient Clinic/Center Primary | 261QM1100X | None listed |
| Military and U.S. Coast Guard Ambulatory Procedure Clinic/Center | 261QM1101X | None listed |
| Military/U.S. Coast Guard Pharmacy | 332000000X | None 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…
28 other providers at this address
- 20th Medgrp-ShawMilitary/U.S. Coast Guard Pharmacy Shaw Afb, SC NPI 1881009033
- Alexander William Ortiz, DOMilitary Health Care Provider Shaw Afb, SC NPI 1356928014
- Collins O. Odukogbe, PharmDPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist Shaw A F B, SC NPI 1295015584
- Dana McLeod, PHARM DPharmacist Shaw A F B, SC NPI 1124398912
- Daniel Anthony Blaz, FNP-BCFamily Nurse Practitioner Shaw Afb, SC NPI 1881786879
- Darrell Mayers, IDMTIndependent Duty Medical Technicians Shaw A F B, SC NPI 1407081409
- Dennis Preston Hooten Ii, IDMTIndependent Duty Medical Technicians Shaw A F B, SC NPI 1205061306
- Elaine M. Alexa, CSWClinical Social Worker Shaw A F B, SC NPI 1316916935
- Eric Black, IDMTIndependent Duty Medical Technicians Shaw Afb, SC NPI 1558025429
- Gilbert Narro, ODOptometrist Shaw A F B, SC NPI 1629063706
- Jaclyn C. Hoffman, DNP, FNPFamily Nurse Practitioner Shaw Afb, SC NPI 1427667765
- James John Labarre, R.PH, PharmDPharmacist Shaw A F B, SC NPI 1598753485
About NPI 1336112440
20th Medgrp-Shaw's National Provider Identifier is 1336112440, issued on Feb 9, 2006. The primary taxonomy on file is Military/U.S. Coast Guard Outpatient Clinic/Center (261QM1100X), and the practice location is in Shaw Afb, SC. The record was last updated on Jun 17, 2025.