Provider Demographics
NPI:1477502029
Name:NMC CAMP LEJEUNE
Entity type:Organization
Organization Name:NMC CAMP LEJEUNE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:UBO MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ROBIN
Authorized Official - Middle Name:
Authorized Official - Last Name:POWELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:910-450-4233
Mailing Address - Street 1:100 BREWSTER BLVD
Mailing Address - Street 2:CODE 08/ZD
Mailing Address - City:CAMP LEJEUNE
Mailing Address - State:NC
Mailing Address - Zip Code:28547-2538
Mailing Address - Country:US
Mailing Address - Phone:910-450-4040
Mailing Address - Fax:910-450-4034
Practice Address - Street 1:100 BREWSTER BLVD
Practice Address - Street 2:CODE 08/ZD
Practice Address - City:CAMP LEJEUNE
Practice Address - State:NC
Practice Address - Zip Code:28547-2538
Practice Address - Country:US
Practice Address - Phone:910-450-4040
Practice Address - Fax:910-450-4034
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NMC CAMP LEJEUNE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-05-10
Last Update Date:2025-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes286500000XHospitalsMilitary Hospital
Yes2865M2000XHospitalsMilitary HospitalMilitary General Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAD000Medicare UPIN