MARTIN ARMY COMMUNITY HOSPITAL


Address: 6069 Walkers Ln, Tmc 12 Camp Rudder, Eglin Afb, FL 32542-8505
Phone: 8508821170

MARTIN ARMY COMMUNITY HOSPITAL (NPI# 1164679601) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1164679601
Entity Type Organization
Organization Name MARTIN ARMY COMMUNITY HOSPITAL
Other Organization Name TMC EGLIN AFB
Practice Address 6069 Walkers Ln
Tmc 12 Camp Rudder
Eglin Afb
FL 32542-8505
Mailing Address 6600 Van Aalst Blvd Bldg 9250
Attn Treasury Mcxb-pp
Fort Benning
GA 31905-2102
Practice Telephone 8508821170
Mailing Telephone 7624082273
Enumeration Date 2008-08-27
Last Update Date 2020-10-01
Authorized Official Name DENNIS JONES (UBO MANAGER)
Authorized Official Telephone 7065445724
Is Organization Subpart Y
Parent Organization Name MARTIN ARMY COMMUNITY HOSPITAL

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 261QM1100X Clinic/Center
Specialization: Military/U.S. Coast Guard Outpatient
Ambulatory Health Care Facilities

Other Provider Identifier

State Issuer Identifier Type Code
PARENT FACILITY NPI 1194730846 01

Other Provider/Organization Names

Other Name Type Code
TMC EGLIN AFB Doing Business As Name - Organization

Other Provider IDs and Locations

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
1780942664 Martin Army Community Hospital Military Hospital 8830 Watkins Ave, Fort Benning, GA 31905-5529 2012-04-27
1588945612 Martin Army Community Hospital Clinic/Center 4327 North El Salvador Way, Eglin Afb, FL 32542 2011-09-02
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
1053624130 Martin Army Community Hospital Clinic/Center 6976 Old Cusseta Rd, Harmony Church, Fort Benning, GA 31905-5431 2010-07-19
1902128077 Martin Army Community Hospital Clinic/Center 7191 Kanopsky Ave, Bldg. #2625, Fort Benning, GA 31905-4540 2010-02-17
1063616266 Martin Army Community Hospital Clinic/Center 9200 Mame Road, Fort Benning, GA 31905 2007-06-12
1245434448 Martin Army Community Hospital Clinic/Center 2622 Soldiers Plaza, Fort Benning, GA 31905 2007-06-12
1083818280 Martin Army Community Hospital Clinic/Center 2828 Sightseeing Road, Fort Benning, GA 31905 2007-06-12
1891999090 Martin Army Community Hospital Clinic/Center 3255 Sand Hill, 11th Abn Div Rd, Fort Benning, GA 31905 2007-06-12

Office Location

Street Address 6069 WALKERS LN
TMC 12 CAMP RUDDER
City EGLIN AFB
State FL
Zip Code 32542-8505

Providers in the same location

NPI Name Taxonomy Address Enumeration
1982786380 Kyle Gene Cooper Physician Assistant 6069 Walkers Ln, Eglin Afb, FL 32542-8505 2006-10-19

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1417440306 Colt Sicher Student in an Organized Health Care Education/Training Program 96th Dental Squadron (afmc), Eglin Afb, Fl 32542, Apo, AA 32542 2018-06-14
1841679529 Matthew Scurria Dentist 340 Boatner Rd. Bldg 2751, 96 Dental Squadron/sgdr, Eglin Afb, FL 32542 2015-05-27
1134518798 96th Medical Support Squadron Military/U.S. Coast Guard Pharmacy 3120 A. Talon Way, Eglin Afb Fld #3, FL 32542 2015-01-20
1598177123 96th Medical Support Squadron Military/U.S. Coast Guard Pharmacy 96 Medical Group Satellite Phcy Memorial Trail, Bldg. 1758, Eglin Afb, FL 32542 2014-06-02
1548602923 Gerald Jordan Novack Psychologist 96mdos/sgow, 307 Boatner Rd, Fpo, AP 32542 2013-07-25
1699112821 Taylor Anne Hahn Obstetrics & Gynecology 96th Medical Group, 307 Boatner Road, Eglin Air Force Base, FL 32542 2013-05-29
1730456948 Nicholas Brandon Sager Dentist 340 Boatner Rd, Eglin Afb, Apo, AA 32542 2011-11-17
1134402662 Jessamy Jae Thornton Student in an Organized Health Care Education/Training Program 340 Boatner Rd, Bldg 2751, Eglin Afb, FL 32542 2011-09-21
1346523974 Mary Elizabeth Sorrentino Dentist 340 Boatner Road, Blgd. 2751, Eglin Afb, FL 32542 2011-09-20
1588945612 Martin Army Community Hospital Clinic/Center 4327 North El Salvador Way, Eglin Afb, FL 32542 2011-09-02
Find all providers in zip 32542

Taxonomy Information

Taxonomy Code 261QM1100X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Military/U.S. Coast Guard Outpatient

Taxonomy Definition

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.
Notes: Source: TRICARE Management Activity Uniform Business Office User’s Guide [1/1/2005: title modified, definition added; 7/1/2006 title modified, definition modified]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1588945612 Martin Army Community Hospital Clinic/Center 4327 North El Salvador Way, Eglin Afb, FL 32542 2011-09-02

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1326553280 Branch Medical Clinic Mayport Clinic/Center 2130 Mayport Rd, Jacksonville, FL 32233-2753 2017-12-13
1871664060 Us Navy Clinic/Center 340 Hulse Rd Bldg 665 Suite 105, 850-452-8051, Pensacola, FL 32508-1089 2006-11-11
1558907873 Uscg Clinic St Petersburg Clinic/Center 600 8th Ave Se, St Petersburg, FL 33701-5030 2019-11-21
1053826917 Branch Medical Clinic Key West Clinic/Center 1300 Douglas Cir, Key West, FL 33040-4536 2017-12-13
1104331065 Branch Medical Clinic Jacksonville Clinic/Center 964 Ajax St, Jacksonville, FL 32214-0001 2017-12-13
1760928923 Uscg Clinic Air Station Miami Clinic/Center 14750 Nw 44th Ct, Opa Locka, FL 33054-2304 2017-01-12
1710206727 Uscg Key West Clinic Clinic/Center 100 Trumbo Rd, Key West, FL 33040-6655 2010-06-01
1114117173 Branch Medical Clinic Panama City Clinic/Center 6703 W Highway 98, Panama City, FL 32407-7000 2007-07-26
1376733527 Branch Medical Clinic Nattc Clinic/Center 760 East Ave, Pensacola, FL 32508-5140 2007-07-25
1265632616 Branch Medical Clinic Whiting Field Clinic/Center 7119 Langley St, Milton, FL 32570-6105 2007-07-24
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Competitor

Search similar providers

City EGLIN AFB
Zip Code 32542

Improve Information

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Dataset Information

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.

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