Organization
AMC EISENHOWER
Active
Parent organization
AMC EISENHOWER
Other names
AMC EISENHOWER-GORDON
Organization subpart
Yes
Provider details
NPI number
Legal business name
AMC EISENHOWER
Authorized official
KIMBERLY BROWN (UBO MANAGER)
(706) 787-7172
Entity
Organization
Contact information
Practice address
300 W HOSPITAL RD BLDG W, FORT GORDON, GA 30905-5741
(706) 787-5811
Mailing address
300 W HOSPITAL RD BLDG W, ATTN MCHF-PAD, FORT GORDON, GA 30905-5741
(706) 787-1125
Taxonomy
Speciality
Code
Description
License number
State
261QM1100X
Military/U.S. Coast Guard Outpatient Clinic/Center
—
—
261QM1101X
Military and U.S. Coast Guard Ambulatory Procedure Clinic/Center
—
—
2865M2000X
Military General Acute Care Hospital
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1497854160/1146643
PHARMACY NPI2/NCPDP
—
01
—
AN2598588
MEDCO
—
Enumeration date
09/20/2006
Last updated
05/21/2025
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