USADC FT. GORDON SNYDER – NPI #1396949657
Clinic/Center

The Defense Health Program or U.S. Coast Guard funded "fixed" facilities or distinct parts of a facility, providing outpatient medical and dental services, primarily for Uniformed Services beneficiaries. A "fixed" facility is a non-temporary, non-deployed facility. It includes mobile specialty units such as Magnetic Resonance Imaging (MRI) units that may furnish services at the "fixed" facility. It includes, as examples, the institutional portion of outpatient encounters (except Ambulatory Procedure Visits), supplies issued (e.g., glasses, ostomy supplies, crutches), and radiology and laboratory studies. Does not include items issued directly to a patient from an outpatient pharmacy or patient transport.

Health Care Provider Taxonomy Code for Clinic/Center

USADC FT. GORDON SNYDER is an AHC clinic located in FORT GORDON, GA. NPPES has assigned the NPI number 1396949657 to USADC FT. GORDON SNYDER on June 12, 2007. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “USADC FT. GORDON SNYDER” is a dba name, the actual legal business name for this organization is EISENHOWER ARMY MEDICAL CENTER. The primary taxonomy selected by this provider is 261QM1100X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center, specializing in Military/U.S. Coast Guard Outpatient

The NPI profile was previously updated about 13 years ago on Jan 29, 2013. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for USADC FT. GORDON SNYDER below.

NPI Profile for
EISENHOWER ARMY MEDICAL CENTER

NPI Number
1396949657
Enumeration Date

(more than 19 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
EISENHOWER ARMY MEDICAL CENTER
Doing Business As (dba): USADC FT. GORDON SNYDER
Primary location
BUILDING 25501, BRAINARD AVENUE
FORT GORDON, GA 30905
Phone: (706) 787-7050 Fax:
Mailing address
300 W HOSPITAL RD BLDG W
ATTN MCHF-PAD
FORT GORDON, GA 30905-5741
Phone: (706) 787-1125 Fax:
Organization Subpart
Yes - USADC FT. GORDON SNYDER is subpart of another organization.
Authorized Official
MARVIN PRIMOS
UBO MANAGER
Phone: (706) 787-7204
Updated
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
261QM1100X
- Clinic/Center / Military/U.S. Coast Guard Outpatient (Primary)

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.