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CAMP SHELBY
NPI 1104031194
Clinic/Center - Military/U.S. Coast Guard Outpatient in Hattiesburg, MS

Active since May 11, 2007
1001 HARDY ST, HATTIESBURG, MS 39401(706) 787-5811 Get Directions Write a Review

NPPES record last updated: January 29, 2013. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Camp Shelby NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CAMP SHELBY (NPI 1104031194) is a healthcare organization registered as a military/u.s. coast guard outpatient in Hattiesburg, Mississippi and active in the NPI registry since May 2007. The organization lists Marvin Primos, Ubo Manager, as its authorized official.

NPPES Registry Identity

NPI1104031194
Entity TypeOrganization
Primary Taxonomy261QM1100X
Legal Business NameEISENHOWER ARMY MEDICAL CENTER
Location Address1001 HARDY STHattiesburg, MS 39401-4165
Mailing Address300 W Hospital Rd Bldg W, Attn Mchf-padFort Gordon, GA 30905-5741 · (706) 787-1125
Phone(706) 787-5811
Organization SubpartYes
Authorized OfficialMarvin PrimosUbo Manager · (706) 787-7204
Enumeration DateMay 11, 2007
Last NPPES UpdateJanuary 29, 2013
✔ NPI 1104031194 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Military/U.S. Coast Guard OutpatientAmbulatory Health Care Facilities
Taxonomy Code261QM1100X
Definition
The Defense Health Program or U.S. Coast Guard funded fixed facilities or distinct parts of a facility, providing outpatient medical and dental services, primarily for Uniformed Services beneficiaries. A fixed facility is a non-temporary, non-deployed facility. It includes mobile specialty units such as Magnetic Resonance Imaging (MRI) units that may furnish services at the fixed facility. It includes, as examples, the institutional portion of outpatient encounters (except Ambulatory Procedure Visits), supplies issued (e.g., glasses, ostomy supplies, crutches), and radiology and laboratory studies. Does not include items issued directly to a patient from an outpatient pharmacy or patient transport.
1001 HARDY ST, Hattiesburg, MS 39401
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Other Names 1

Doing Business AsCamp Shelby

Other Identifiers 2

Medicare UPINVAD000
Medicare UPINOTH000

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Eisenhower Army Medical Center's NPI number?

The NPI number for Eisenhower Army Medical Center is 1104031194. It was assigned to this organization in the NPPES registry on May 11, 2007. The provider is doing business as Camp Shelby.

Where is Eisenhower Army Medical Center located?

Eisenhower Army Medical Center is located at 1001 Hardy St, Hattiesburg, MS 39401. The listed phone number is (706) 787-5811.

What is Eisenhower Army Medical Center's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Military/U.S. Coast Guard Outpatient, with taxonomy code 261QM1100X.

When was this NPI record last updated?

The NPPES record for Eisenhower Army Medical Center was last updated on January 29, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.