Healthcare Provider Details

I. General information

NPI: 1477502029
Provider Name (Legal Business Name): NAVAL MEDICAL CENTER CAMP LEJEUNE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/10/2006
Last Update Date: 12/03/2025
Certification Date: 12/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 BREWSTER BLVD CODE 08/ZD
CAMP LEJEUNE NC
28547-2538
US

IV. Provider business mailing address

100 BREWSTER BLVD
CAMP LEJEUNE NC
28547-2575
US

V. Phone/Fax

Practice location:
  • Phone: 910-450-4040
  • Fax: 910-450-4034
Mailing address:
  • Phone: 910-450-4040
  • Fax: 910-450-4034

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2865M2000X
TaxonomyMilitary General Acute Care Hospital
License Number
License Number State

VIII. Authorized Official

Name: MIKAELA COTE
Title or Position: UBO MANAGER
Credential:
Phone: 910-450-4192