# KIMBROUGH ACC MILITARY MTF

> 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:** KIMBROUGH ACC MILITARY MTF
- **Other names:** AHC KIRK-ABERDEEN PRVNG GD
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1902955420
- **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, ABERDEEN PROVING GROUND, MD 21005-5131
- **Practice address phone:** (410) 278-1824
- **Practice address fax:** (410) 278-1779
- **Mailing address:** 2480 LLEWELLYN AVE, CDR USAMEDDAC MCXR-BD STE 5800, FORT MEADE, MD 20755-7081
- **Mailing address phone:** (301) 677-8800

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM1100X | Military/U.S. Coast Guard Outpatient Clinic/Center | — | NULL | Yes |
| 332000000X | Military/U.S. Coast Guard Pharmacy | — | NULL | — |
| 341800000X | Military/U.S. Coast Guard Transport | — | NULL | — |

## Other

- **Enumeration date:** 01/10/2007
- **Last updated:** 04/01/2015

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 1164507703 | PARENT FACILITY NPI | — |
| 01 | — | AN2598588 | MEDCO | — |