# KIMBROUGH ACC MILITARY MTF

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** KIMBROUGH ACC MILITARY MTF
- **Other names:** OHC EDGEWOOD ARS
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1073729745
- **Legal business name:** KIMBROUGH ACC MILITARY MTF
- **Authorized official:** TERRI KIMBROW (UBO MANAGER)
- **Authorized official phone:** (301) 677-8512

## Contact information

- **Practice address:** 2501 OAKINGTON ST, BUILDING E-4110, ABERDEEN PROVING GROUND, MD 21005-5131
- **Practice address phone:** (410) 278-1824
- **Mailing address:** 2480 LLEWELLYN AVE, CDR USAMEDDAC MCXR-BD STE 5800, FORT MEADE, MD 20755-7081
- **Mailing address phone:** (301) 677-8253

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM1100X | Military/U.S. Coast Guard Outpatient Clinic/Center | — | — | Yes |

## Other

- **Enumeration date:** 05/16/2007
- **Last updated:** 12/18/2012

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 1164507703 | PARENT FACILITY NPI | — |