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General NPI Number Information
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NPI Number | 1235508557
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Entity Type | Organization
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Legal Business Name | UNITED STATES NAVY
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Dates
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Enumeration Date | 09/16/2015
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Last Update Date | 09/16/2015
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Provider Practice Location Address
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Address Line | PSC BOX 20098 HQ AND SERVICE CO, 1ST BN, 6TH MARINE REGT, 2D MARDIV
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City | CAMP LEJEUNE
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State | NC
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Zip | 28542-0098
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Country | US
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Telephone | 910-450-5150
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Fax |
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Provider Business Mailing Address
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Address Line | PSC BOX 20098 HQ AND SERVICE CO 1ST BN, 6TH MARINE REGT, 2D MARDIV
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City | CAMP LEJEUNE
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State | NC
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Zip | 28542-0098
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DIVISION SURGEON/MEDICAL PLANNER
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Name | DAVID VARNEY
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Credential |
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Telephone | 910-451-8282
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1100X
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Taxonomy Name | Military/U.S. Coast Guard Outpatient Clinic/Center
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License Number |
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License Number State |
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