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EISENHOWER ARMY MEDICAL CENTER NPI 1215036983


NPI Information

NPI: 1215036983
Provider Name: EISENHOWER ARMY MEDICAL CENTER

Doing Business As: FT EISENHOWER CONNELLY PHARMACY

Classification: Military/U.S. Coast Guard Pharmacy - 332000000X
Entity Type: Organization
Address:
AVENUE B BLDG 29709
MARK CONNELLY HEALTH CLINIC
FT GORDON, GA
ZIP 30905
Phone: (706) 787-5167
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EISENHOWER ARMY MEDICAL CENTER is a military us coast guard pharmacy in Ft Gordon, GA. The provider is 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. EISENHOWER ARMY MEDICAL CENTER NPI is 1215036983. The provider is registered as an organization entity type.
The provider Is Doing Business As Ft Eisenhower Connelly Pharmacy.

The provider's business location address is:

AVENUE B BLDG 29709
MARK CONNELLY HEALTH CLINIC
FT GORDON, GA
ZIP 30905
Phone: (706) 787-5167
Fax: (706) 787-6175

The provider's authorized official is Hector Morales .
The authorized official title is Dha Pod Sr Program Analyst and has the following contact phone number (210) 536-6650.

The enumeration date for this NPI number is 9/21/2006 and was last updated on 10/25/2023.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1332000000XMilitary/U.S. Coast Guard PharmacyYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
12020249OTHERPK

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.