Organization
AMC EISENHOWER
Active
Parent organization
AMC EISENHOWER
Other names
DoD SOUTHCOM ePhcy
Organization subpart
Yes
Provider details
NPI number
Legal business name
AMC EISENHOWER
Authorized official
HECTOR MORALES (CHIEF DHA PASS)
(210) 536-6650
Entity
Organization
Contact information
Practice address
9301 NW 33RD ST, ARMY HEALTH CLINIC SOUTHCOM, DORAL, FL 33172-1202
(305) 437-1749
(305) 437-1149
Mailing address
EISENHOWER ARMY MEDICAL CENTER, 300 W HOSPITAL RD ATTN: MCHF-PAD, FT GORDON, GA 30905-5741
Taxonomy
Speciality
Code
Description
License number
State
332000000X
Military/U.S. Coast Guard Pharmacy
Primary
—
—
333600000X
Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2163700
PK
—
Enumeration date
08/22/2016
Last updated
06/11/2025
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