NAVAL MEDICAL CENTER CAMP LEJEUNE (NPI# 1710252499) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710252499 |
| Entity Type | Organization |
| Organization Name | NAVAL MEDICAL CENTER CAMP LEJEUNE |
| Practice Address |
A Street Bldg # Rr 440 Camp Lejeune NC 28542-0117 |
| Mailing Address |
Psc Box 20117 Camp Lejeune NC 28542-0117 |
| Practice Telephone | 9104400011 |
| Practice Fax Number | 9104401095 |
| Mailing Telephone | 9104400011 |
| Mailing Fax Number | 2102952567 |
| Enumeration Date | 2012-03-14 |
| Last Update Date | 2017-12-20 |
| Authorized Official Name | MR. WILLIAM MICHAEL CONDON (NAVY MEDICINE UBO PROGRAM MANAGER) |
| Authorized Official Telephone | 2404013643 |
| Is Organization Subpart | Y |
| Parent Organization Name | NAVAL MEDICAL CENTER CAMP LEJEUNE |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332000000X | Military/U.S. Coast Guard Pharmacy | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PK | 2134220 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427435585 | Naval Medical Center Camp Lejeune | Military/U.S. Coast Guard Pharmacy | Stone St. Extention, Bldg Nh200, Camp Lejeune, NC 28547 | 2015-04-28 |
| 1821400516 | Naval Medical Center Camp Lejeune | Military/U.S. Coast Guard Pharmacy | Brewster Blvd Bldg Nh100, Usn-naval Hospital, Camp Lejeune, NC 28547-0100 | 2014-05-29 |
| 1700985025 | Naval Medical Center Camp Lejeune | Military/U.S. Coast Guard Pharmacy | 100 Brewster Blvd, Phcy Deptnaval Hosp Bld 416, Camp Lejeune, NC 28547-2538 | 2006-09-22 |
| 1619076932 | Naval Medical Center Camp Lejeune | Military/U.S. Coast Guard Pharmacy | 100 Brewster Blvd, Phcy Deptnaval Hosp G770, Camp Lejeune, NC 28547-2575 | 2006-09-22 |
| 1528167848 | Naval Medical Center Camp Lejeune | Military/U.S. Coast Guard Pharmacy | 100 Brewster Blvd, Phcy Dept Naval Hosp Fc520, Camp Lejeune, NC 28547-2538 | 2006-09-22 |
| 1982703294 | Naval Medical Center Camp Lejeune | Military/U.S. Coast Guard Pharmacy | 100 Brewster Blvd, Pharmacy Dept Naval Hosp Bldg 416, Camp Lejeune, NC 28547-2538 | 2006-09-22 |
| 1891894119 | Naval Medical Center Camp Lejeune | Military/U.S. Coast Guard Pharmacy | 100 Brewster Blvd, Phcy Dept Naval Hosp As100, Camp Lejeune, NC 28547-2538 | 2006-09-22 |
| 1659470979 | Naval Medical Center Camp Lejeune | Military/U.S. Coast Guard Pharmacy | 100 Brewster Blvd, Pharmacy Deptnaval Hosp Bld 123, Camp Lejeune, NC 28547-2538 | 2006-09-22 |
| 1750480059 | Naval Medical Center Camp Lejeune | Military/U.S. Coast Guard Pharmacy | 100 Brewster Blvd, Pharmacy Deptnaval Hosp, Camp Lejeune, NC 28547-2575 | 2006-09-22 |
| 1437258753 | Naval Medical Center Camp Lejeune | Military/U.S. Coast Guard Pharmacy | 100 Brewster Blvd, Phcy Dept Naval Hosp Bb118, Camp Lejeune, NC 28547-2575 | 2006-09-22 |
| Street Address |
A STREET BLDG # RR 440 |
| City | CAMP LEJEUNE |
| State | NC |
| Zip Code | 28542-0117 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730794439 | Lauren Marie Barton | Dentist | H M Smith Blvd, Bldg Fc-308, Camp Lejeune, NC 28542 | 2020-09-10 |
| 1003444928 | Andres Martin Rodoni | Military Health Care Provider | 2nd Reconnaissance Battalion, Camp Lejune, NC 28542 | 2020-03-27 |
| 1699306670 | Dominick Ciampo | Military Health Care Provider | A66 Boat Basin Road, Camp Lejeune, NC 28542 | 2020-01-29 |
| 1881243525 | Alexander Thomas Rodgers | Military Health Care Provider | 2nd Raider Battalion, A66 Boat Basin Rd, Camp Lejeune, NC 28542 | 2019-09-05 |
| 1992352454 | Kirsten Janel Snow | Physician Assistant | Hm Smith Boulevard, Bldg Fc-308, Camp Lejeune, NC 28542 | 2019-08-20 |
| 1639735947 | Cody Robert Patton | Military Health Care Provider | 3rd Marine Raider Battalion, Bldg 614, Camp Lejeune, Nc, NC 28542 | 2019-05-13 |
| 1558832345 | Nathaniel Franklin Campbell | Military Health Care Provider | Rr 612 Everett Creek Rd, Camp Lejuene, Fpo, AE 28542 | 2018-12-06 |
| 1578032504 | Brendon Earl Dumas | Military Health Care Provider | Rr612 Everett Creek Road, Camp Lejeune, NC 28542 | 2018-11-20 |
| 1053896514 | Roy Atallah | Military Health Care Provider | 2nd Marine Raider Battalion, Camp Lejeune, NC 28542 | 2018-10-01 |
| 1316422975 | Zachary Thomas Monahan | General Practice | Hm Smith Boulevard Bldg Fc-308, Camp Lejeune, NC 28542 | 2018-09-30 |
| Find all providers in zip 28542 | ||||
| Taxonomy Code | 332000000X |
| Grouping | Suppliers |
| Classification | Military/U.S. Coast Guard Pharmacy |
| A Department of Defense (DoD) or U.S. Coast Guard entity whose primary function is to store, prepare and dispense pharmaceuticals and other associated items to Uniformed Services beneficiaries. These pharmacies may be associated with a DoD or U.S. Coast Guard clinic, DoD Hospital or freestanding. Usually associated with outpatient services. |
| Notes: Source: TRICARE Management Activity Uniform Business Office User’s Guide [1/1/2005: new; 7/1/2006: modified title, modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427435585 | Naval Medical Center Camp Lejeune | Military/U.S. Coast Guard Pharmacy | Stone St. Extention, Bldg Nh200, Camp Lejeune, NC 28547 | 2015-04-28 |
| 1821400516 | Naval Medical Center Camp Lejeune | Military/U.S. Coast Guard Pharmacy | Brewster Blvd Bldg Nh100, Usn-naval Hospital, Camp Lejeune, NC 28547-0100 | 2014-05-29 |
| 1700985025 | Naval Medical Center Camp Lejeune | Military/U.S. Coast Guard Pharmacy | 100 Brewster Blvd, Phcy Deptnaval Hosp Bld 416, Camp Lejeune, NC 28547-2538 | 2006-09-22 |
| 1619076932 | Naval Medical Center Camp Lejeune | Military/U.S. Coast Guard Pharmacy | 100 Brewster Blvd, Phcy Deptnaval Hosp G770, Camp Lejeune, NC 28547-2575 | 2006-09-22 |
| 1528167848 | Naval Medical Center Camp Lejeune | Military/U.S. Coast Guard Pharmacy | 100 Brewster Blvd, Phcy Dept Naval Hosp Fc520, Camp Lejeune, NC 28547-2538 | 2006-09-22 |
| 1982703294 | Naval Medical Center Camp Lejeune | Military/U.S. Coast Guard Pharmacy | 100 Brewster Blvd, Pharmacy Dept Naval Hosp Bldg 416, Camp Lejeune, NC 28547-2538 | 2006-09-22 |
| 1891894119 | Naval Medical Center Camp Lejeune | Military/U.S. Coast Guard Pharmacy | 100 Brewster Blvd, Phcy Dept Naval Hosp As100, Camp Lejeune, NC 28547-2538 | 2006-09-22 |
| 1659470979 | Naval Medical Center Camp Lejeune | Military/U.S. Coast Guard Pharmacy | 100 Brewster Blvd, Pharmacy Deptnaval Hosp Bld 123, Camp Lejeune, NC 28547-2538 | 2006-09-22 |
| 1750480059 | Naval Medical Center Camp Lejeune | Military/U.S. Coast Guard Pharmacy | 100 Brewster Blvd, Pharmacy Deptnaval Hosp, Camp Lejeune, NC 28547-2575 | 2006-09-22 |
| 1437258753 | Naval Medical Center Camp Lejeune | Military/U.S. Coast Guard Pharmacy | 100 Brewster Blvd, Phcy Dept Naval Hosp Bb118, Camp Lejeune, NC 28547-2575 | 2006-09-22 |
| Find all providers in CAMP LEJEUNE | ||||
| City | CAMP LEJEUNE |
| Zip Code | 28542 |
Please comment or provide details below to improve the information on NAVAL MEDICAL CENTER CAMP LEJEUNE.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.