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CONNELLY HEALTH CLINIC
NPI 1427131432
Clinic/Center - Military/U.S. Coast Guard Outpatient in Fort Gordon, GA

Active since October 23, 2006
29709 B STREET, FORT GORDON, GA 30905(706) 787-5811 Get Directions Write a Review

NPPES record last updated: January 31, 2013. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Connelly Health Clinic NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CONNELLY HEALTH CLINIC (NPI 1427131432) is a healthcare organization registered as a military/u.s. coast guard outpatient in Fort Gordon, Georgia and active in the NPI registry since October 2006. The organization lists Marvin Primos, Ubo Manager, as its authorized official.

NPPES Registry Identity

NPI1427131432
Entity TypeOrganization
Primary Taxonomy261QM1100X
Legal Business NameEISENHOWER ARMY MEDICAL CENTER
Location Address29709 B STREETFort Gordon, GA 30905-5741
Mailing Address300 W Hospital Rd Bldg W, Attn Mchf-padFort Gordon, GA 30905-5741 · (706) 787-1125
Phone(706) 787-5811
Organization SubpartYes
Authorized OfficialMarvin PrimosUbo Manager · (706) 787-7204
Enumeration DateOctober 23, 2006
Last NPPES UpdateJanuary 31, 2013
✔ NPI 1427131432 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyClinic/Center · Military/U.S. Coast Guard OutpatientAmbulatory Health Care Facilities
Taxonomy Code261QM1100X
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.
Also ListedMilitary/U.S. Coast Guard PharmacyTaxonomy 332000000X
29709 B STREET, Fort Gordon, GA 30905
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Other Names 1

Doing Business AsConnelly Health Clinic

Other Identifiers 3

Medicare UPINVAD000
Medicare UPINOTH000
Other1578660742Parent Mtf Npi

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

BARBARA ELLEN FIGUEROA LPN
Licensed Practical Nurse
29709 B STREET, CONNELLY HEALTH CLINIC
FORT GORDON, GA 30905
Richmond County (706) 787-5174

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Eisenhower Army Medical Center's NPI number?

The NPI number for Eisenhower Army Medical Center is 1427131432. It was assigned to this organization in the NPPES registry on October 23, 2006. The provider is doing business as Connelly Health Clinic.

Where is Eisenhower Army Medical Center located?

Eisenhower Army Medical Center is located at 29709 B Street, Fort Gordon, GA 30905. The listed phone number is (706) 787-5811.

What is Eisenhower Army Medical Center's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Military/U.S. Coast Guard Outpatient, with taxonomy code 261QM1100X.

When was this NPI record last updated?

The NPPES record for Eisenhower Army Medical Center was last updated on January 31, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.