EISENHOWER ARMY MEDICAL CENTER (NPI# 1457450066) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457450066 |
| Entity Type | Organization |
| Organization Name | EISENHOWER ARMY MEDICAL CENTER |
| Other Organization Name | MACPHERSON REFILL PHCY |
| Practice Address |
Bldg 366 Ft Macpherson GA 30330-5000 |
| Mailing Address |
300 W Hospital Rd Attn Mchf-pad Fort Gordon GA 30905-5741 |
| Practice Telephone | 4044640296 |
| Practice Fax Number | 4044640303 |
| Mailing Telephone | 7067871125 |
| Enumeration Date | 2006-09-21 |
| Last Update Date | 2013-02-07 |
| Authorized Official Name | HECTOR MORALES (MGR PHRMCY OPERATIONS CNTR) |
| Authorized Official Telephone | 2102218274 |
| Is Organization Subpart | Y |
| Parent Organization Name | EISENHOWER ARMY MEDICAL CENTER |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332000000X | Military/U.S. Coast Guard Pharmacy | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OTHER ID NUMBER-COMMERCIAL NUMBER | 1147138 | 01 |
| Other Name | Type Code |
|---|---|
| MACPHERSON REFILL PHCY | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548672173 | Eisenhower Army Medical Center | Military/U.S. Coast Guard Pharmacy | Rodriguez Army Health Clinic (rahc), Bldg 21 Chrisman Rd., Fort Buchanan, PR 00934-3400 | 2014-06-02 |
| 1053661173 | Eisenhower Army Medical Center | Military/U.S. Coast Guard Pharmacy | Building 21, 21 Chrisman Rd, Ft Buchanan, PR 00934-3400 | 2012-09-17 |
| 1588868848 | Eisenhower Army Medical Center | Clinic/Center | 320 Hospital Road, Fort Gordon, GA 30905 | 2007-06-12 |
| 1396949657 | Eisenhower Army Medical Center | Clinic/Center | Building 25501, Brainard Avenue, Fort Gordon, GA 30905 | 2007-06-12 |
| 1619170198 | Eisenhower Army Medical Center | Clinic/Center | 1701 Hardee Avenue, S.w., Fort Mcpherson, GA 30330 | 2007-06-11 |
| 1750584363 | Eisenhower Army Medical Center | Clinic/Center | 1450 14th St, Hattiesburg, MS 39407-0001 | 2007-06-10 |
| 1104031194 | Eisenhower Army Medical Center | Clinic/Center | 1001 Hardy St, Hattiesburg, MS 39401-4165 | 2007-05-11 |
| 1346302494 | Eisenhower Army Medical Center | Military Hospital | 3395 Highland Park Pl, Memphis, TN 38111-4744 | 2006-12-15 |
| 1427131432 | Eisenhower Army Medical Center | Military/U.S. Coast Guard Pharmacy | 29709 B Street, Fort Gordon, GA 30905-5741 | 2006-10-23 |
| 1104925361 | Eisenhower Army Medical Center | Military/U.S. Coast Guard Pharmacy | Bldg 21, Ft Buchanan, PR 00934 | 2006-09-22 |
| Street Address |
BLDG 366 |
| City | FT MACPHERSON |
| State | GA |
| Zip Code | 30330-5000 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619170198 | Eisenhower Army Medical Center | Clinic/Center | 1701 Hardee Avenue, S.w., Fort Mcpherson, GA 30330 | 2007-06-11 |
| 1114120821 | Sonja Diane Foots | Registered Nurse | 1701 Hardee Ave S.w., Fort Mcpherson, AL 30330 | 2007-06-08 |
| 1790988657 | Dianne Terrell Smith I | Registered Nurse | 1701 Hardee Ave. S W, Fort Mcpherson, GA 30330 | 2007-06-07 |
| 1639389042 | Ileana Rogers | Registered Nurse | 1701 Hardee Avenue S. W., Fort Mcpherson, GA 30330 | 2007-05-23 |
| 1205981974 | Lawrence Joel Army Health Clinic | Clinic/Center | 1701 Hardee Ave S. W., Fort Mcpherson, Atlanta, GA 30330 | 2007-01-24 |
| 1376696856 | Christine G. Casey | Internal Medicine | 1701 Hardee Ave Se, Lawrence Joel Health Clini, Ft Mcpherson, GA 30330 | 2007-01-19 |
| 1023180577 | Tony Serrano-padin | Family Medicine | 1701 Hardee Ave. Sw, Bldg 125, Fort Mcpherson - Army Health Clinic, Atlanta, GA 30330 | 2006-11-13 |
| 1083796072 | Brenda Gale Hubbard | Pharmacist | 1701 Hardee Ave, Ft Mcpherson, GA 30330 | 2006-10-19 |
| 1679774848 | Corrinne Anne Thames | Licensed Practical Nurse | 1701 Hardee Avenue, Fort Mcpherson, GA 30330 | 2007-05-29 |
| 1912108101 | A. Z. Hooker II | Licensed Practical Nurse | 1701 Hardee Avenue Sw, Ft.pherson, GA 30330 | 2007-05-29 |
| Find all providers in zip 30330 | ||||
| Taxonomy Code | 332000000X |
| Grouping | Suppliers |
| Classification | Military/U.S. Coast Guard Pharmacy |
| A Department of Defense (DoD) or U.S. Coast Guard entity whose primary function is to store, prepare and dispense pharmaceuticals and other associated items to Uniformed Services beneficiaries. These pharmacies may be associated with a DoD or U.S. Coast Guard clinic, DoD Hospital or freestanding. Usually associated with outpatient services. |
| Notes: Source: TRICARE Management Activity Uniform Business Office User’s Guide [1/1/2005: new; 7/1/2006: modified title, modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023378403 | Martin Army Community Hospital | Military/U.S. Coast Guard Pharmacy | 1100 Brookstone Centre Pkwy Rm 128, Columbus, GA 31904-4577 | 2012-05-21 |
| 1477811149 | Winn - Third Party Insurance | Military/U.S. Coast Guard Pharmacy | Bldg 8435, 306 Vanguard Road, Ft Stewart, GA 31314 | 2012-05-01 |
| 1992009401 | Martin Army Community Hospital | Military/U.S. Coast Guard Pharmacy | 6998 Old Cusseta Rd Bldg 4202, Fort Benning, GA 31905-5431 | 2010-12-28 |
| 1427131432 | Eisenhower Army Medical Center | Military/U.S. Coast Guard Pharmacy | 29709 B Street, Fort Gordon, GA 30905-5741 | 2006-10-23 |
| 1790875029 | Winn-third Party Insurance | Military/U.S. Coast Guard Pharmacy | Hunter Af Bldg, Bldg 1450, Savannah, GA 31409 | 2006-10-16 |
| 1497854160 | Eisenhower Army Medical Center | Military/U.S. Coast Guard Pharmacy | East Hospital Rd, Bldg 300 Rm 2c22, Ft Gordon, GA 30905 | 2006-09-21 |
| 1649379314 | Martin Army Community Hospital | Military/U.S. Coast Guard Pharmacy | Marne Rd Bldg 9200, Ft Benning, GA 31905 | 2006-09-21 |
| 1548369150 | Martin Army Community Hospital | Military/U.S. Coast Guard Pharmacy | Marne Rd Bldg 9230, Ft Benning, GA 31905 | 2006-09-21 |
| 1215036983 | Eisenhower Army Medical Center | Military/U.S. Coast Guard Pharmacy | Avenue B Bldg 29709, Mark Connelly Health Clinic, Ft Gordon, GA 30905 | 2006-09-21 |
| 1467559211 | Winn-third Party Insurance | Military/U.S. Coast Guard Pharmacy | 1061 Harmon Ave Ste 2j11b, Fort Stewart, GA 31314-5641 | 2006-09-20 |
| Find all providers with the same taxonomy | ||||
| City | FT MACPHERSON |
| Zip Code | 30330 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.