# EISENHOWER ARMY MEDICAL CENTER

> 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:** EISENHOWER ARMY MEDICAL CENTER
- **Other names:** RODRIGUEZ ARMY HEALTH CLINIC-FT. BUCHANAN
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1770798316
- **Legal business name:** EISENHOWER ARMY MEDICAL CENTER
- **Authorized official:** MARVIN PRIMOS (UBO MANAGER)
- **Authorized official phone:** (706) 787-7204

## Contact information

- **Practice address:** 21 CHRISMAN RD, FORT BUCHANAN, PR 00934-4519
- **Practice address phone:** (706) 787-5811
- **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 | — | — | Yes |
| 332000000X | Military/U.S. Coast Guard Pharmacy | — | — | — |

## Other

- **Enumeration date:** 05/14/2007
- **Last updated:** 01/29/2013

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 1578660742 | PARENT MTF NPI | — |