# EISENHOWER ARMY MEDICAL CENTER

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** EISENHOWER ARMY MEDICAL CENTER
- **Other names:** USADC FT. GORDON SNYDER
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1396949657
- **Legal business name:** EISENHOWER ARMY MEDICAL CENTER
- **Authorized official:** MARVIN PRIMOS (UBO MANAGER)
- **Authorized official phone:** (706) 787-7204

## Contact information

- **Practice address:** BUILDING 25501, BRAINARD AVENUE, FORT GORDON, GA 30905
- **Practice address phone:** (706) 787-7050
- **Mailing address:** 300 W HOSPITAL RD BLDG W, ATTN MCHF-PAD, FORT GORDON, GA 30905-5741
- **Mailing address phone:** (706) 787-1125

## Taxonomy

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

## Other

- **Enumeration date:** 06/12/2007
- **Last updated:** 01/29/2013