Organization
EISENHOWER ARMY MEDICAL CENTER
Active
Other names
GORDON PX PHCY
Organization subpart
No
Provider details
NPI number
Authorized official
HECTOR MORALES (CHIEF DHA PASS)
(210) 536-6650
Entity
Organization
Contact information
Practice address
3RD AVENUE, BLDG 38200, FT GORDON, GA 30905
(706) 787-6155
(706) 787-6175
Mailing address
300 W HOSPITAL RD, ATTN MCHF-PAD, FORT GORDON, GA 30905-5741
(706) 787-6155
Taxonomy
Speciality
Code
Description
License number
State
332000000X
Military/U.S. Coast Guard Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2020248
PK
—
Enumeration date
09/21/2006
Last updated
06/24/2015
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