Provider Demographics
NPI:1821400516
Name:NAVAL MEDICAL CENTER CAMP LEJEUNE
Entity Type:Organization
Organization Name:NAVAL MEDICAL CENTER CAMP LEJEUNE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF DHA POSC
Authorized Official - Prefix:
Authorized Official - First Name:HECTOR
Authorized Official - Middle Name:
Authorized Official - Last Name:MORALES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-536-6650
Mailing Address - Street 1:PO BOX 10100 CODE 0820
Mailing Address - Street 2:NAVAL HOSPITAL CAMP LEJEUNE
Mailing Address - City:CAMP LEJEUNE
Mailing Address - State:NC
Mailing Address - Zip Code:28347
Mailing Address - Country:US
Mailing Address - Phone:910-450-4172
Mailing Address - Fax:
Practice Address - Street 1:BREWSTER BLVD BLDG NH100
Practice Address - Street 2:USN-NAVAL HOSPITAL
Practice Address - City:CAMP LEJEUNE
Practice Address - State:NC
Practice Address - Zip Code:28547-0100
Practice Address - Country:US
Practice Address - Phone:910-450-4171
Practice Address - Fax:910-450-4952
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NAVAL MEDICAL CENTER CAMP LEJEUNE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-05-29
Last Update Date:2023-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332000000XSuppliersMilitary/U.S. Coast Guard Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2145968OtherPK