Eisenhower Army Medical Center in Fort Gordon - Military/u.s. Coast Guard Outpatient
Eisenhower Army Medical Center - NPI 1164636320
Eisenhower Army Medical Center is a Military/u.s. Coast Guard Outpatient in Fort Gordon, Georgia. Eisenhower Army Medical Center practices all healthcare services and medical treatments related to Military/u.s. Coast Guard Outpatient. The NPI Number for Eisenhower Army Medical Center is 1164636320. The last update date is 2015-01-05.
Eisenhower Army Medical Center's current location address is 300 W Hospital Rd Bldg W, Fort Gordon, Georgia. You can contact this provider via phone number 7067871125. The mailing address for Eisenhower Army Medical Center is 300 W Hospital Rd Bldg W, Fort Gordon, Georgia. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Eisenhower Army Medical Center |
|---|---|
| Address | 300 W Hospital Rd Bldg W, Fort Gordon, Georgia |
| Phone Number | 7067871125 |
| Fax Number | |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | UBO MANAGE |
|---|---|
| Authorized Official Name | Primos Marvin |
| Telephone Number | 7067877204 |
NPI Number Detail
| NPI Number | 1164636320 |
|---|---|
| Provider Enumeration Date | 2007-05-09 |
| Last Updated Date | 2015-01-05 |
Provider Mailing Address Detail
| Address | 300 W Hospital Rd Bldg W |
|---|---|
| City | Fort Gordon |
| State | Georgia (GA) |
| Post Code | 309055741 |
| Phone Number | 7067871125 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Military/u.s. Coast Guard Outpatient |
|---|---|
| Taxonomy | 261Qm1100X |
|
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-dep |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 1578660742 | PARENT MTF NPI |
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What is the unique identifier code issued to Eisenhower Army Medical Center by the Centers for Medicare & Medicaid Services (CMS)?
The Eisenhower Army Medical Center has been assigned the NPI (National Provider Identifier) 1164636320. This 10-digit code serves as a unique identification number for healthcare providers, issued by the CMS.
Where is the Eisenhower Army Medical Center located?
The Eisenhower Army Medical Center is located at 300 W Hospital Rd Bldg W, Fort Gordon, GA 309055741.
What is the Eisenhower Army Medical Center's specialty and taxonomy code?
The Eisenhower Army Medical Center's specialty is Military/u.s. Coast Guard Outpatient, and the corresponding taxonomy code is 261Qm1100X.
On what date did Eisenhower Army Medical Center receive its 1164636320 assignment from the Centers for Medicare & Medicaid Services?
The Eisenhower Army Medical Center was assigned its 1164636320 on 2007-05-09, which is the date when this unique identifier was issued to the organization by the Centers for Medicare & Medicaid Services.
As of what date was the information regarding Eisenhower Army Medical Center, such as address, specialty, and other details, last verified and confirmed to be up-to-date?
The information related to Eisenhower Army Medical Center, including its address, specialty, and other relevant details, was last verified and confirmed to be up-to-date on 2015-01-05.
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