NPI age
19 years
Enumerated 2006-10-23
● Active Type 2 · Organization
Subpart
Eisenhower Army Medical Center
Eisenhower Army Medical Center is 1 of 46 clinic/center organizations in Georgia.
Primary specialty
Clinic/Center
Plus 1 secondary
Practice locations
1
0 secondary on file
Status
Active
No deactivations on record
Authorized official
Primos
Ubo Manager
Last NPPES update
2013-01-31
Source: monthly bulk 2026-05
How this organization compares
Across 46 active clinic/center providers in Georgia.
NPI age
19 years
≈ at median (18 yr)
Practice locations
1
0 secondary on file
Subspecialties
1
In the 6% of peers with subspecialties
NPI lifetime · 2006 → 2026
2006-10Enumerated in NPPES
2006
2026
Where they practice
Primary practice location
29709 B Street
Fort Gordon, GA 309055741
Mailing address
300 W Hospital Rd Bldg W, Attn McHf-Pad
Fort Gordon, GA 309055741
Authorized official
Marvin Primos
Ubo Manager
📞 7067877204
Individual providers at this organization
1 individual provider on file at this primary practice address.
- Barbara Figueroa, LPN Licensed Practical Nurse NPI 1790951697
Specialties
-
Clinic/Center PrimaryThe 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...
-
Military/U.S. Coast Guard PharmacyA 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...
Identifiers
| Type | Value | Notes |
|---|---|---|
| 01 | 1578660742 | PARENT MTF NPI |
Other names on file (1)
Doing-business-as, former, and alternate names recorded by NPPES.
-
CONNELLY HEALTH CLINIC
Practice context
Multi-provider organization. 1 individual provider on file at this primary address.
Subpart of Eisenhower Army Medical Center.
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- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
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