Organization
MARTIN ARMY COMMUNITY HOSPITAL
Active
Parent organization
MARTIN ARMY COMMUNITY HOSPITAL
Other names
CTMC 2-HARMONY CHURCH
Organization subpart
Yes
Provider details
NPI number
Legal business name
MARTIN ARMY COMMUNITY HOSPITAL
Authorized official
KERTREDIA DAVIS CCA, CPAR, CRCR (UBO MANAGER)
(762) 408-0007
Entity
Organization
Contact information
Practice address
6976 OLD CUSSETA RD, HARMONY CHURCH, FORT BENNING, GA 31905-5431
(706) 544-3278
Mailing address
6600 VAN AALST BLVD BLDG 9250, ATTN TREASURY OFFICE MCXB-PP, FORT BENNING, GA 31905-2102
(706) 544-5724
Taxonomy
Speciality
Code
Description
License number
State
261QM1100X
Military/U.S. Coast Guard Outpatient Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1194730846
PARENT BILLING NPI
—
Enumeration date
07/19/2010
Last updated
01/20/2021
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