# US ARMY HEALTH CLINIC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Parent organization:** EVANS ARMY COMMUNITY HOSPITAL
- **Other names:** OHC DUGWAY PROVING GROUND
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1497702591
- **Legal business name:** EVANS ARMY COMMUNITY HOSPITAL
- **Authorized official:** ELIZABETH BURLINGAME (UBO MANAGER)
- **Authorized official phone:** (719) 526-7291

## Contact information

- **Practice address:** 5116 KISTER AVE, RM \#119, DUGWAY, UT 84022-1097
- **Practice address phone:** (435) 831-3313
- **Practice address fax:** (435) 831-3360
- **Mailing address:** 5116 KISTER AVE, ATTN: MSA OFFICE, DUGWAY, UT 84022-1097
- **Mailing address phone:** (435) 831-3313
- **Mailing address fax:** (435) 831-3360

## Taxonomy

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

## Other

- **Enumeration date:** 05/27/2006
- **Last updated:** 11/17/2015

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 4609307 | NCPDP | — |
| 01 | — | AN2598588 | MEDCO | — |