Organization
US ARMY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES FARRIS JAMMEL (NURSE CASE MANAGER)
(912) 435-1359
Entity
Organization
Contact information
Practice address
703 E 9 STREET, FORT STEWART, GA 31314
(912) 435-1359
Mailing address
410 NW 161ST AVE, PEMBROKE PINES, FL 33028-1164
(954) 993-3118
Taxonomy
Speciality
Code
Description
License number
State
261QE0002X
Emergency Care Clinic/Center
Primary
2572192
FL
Other
Enumeration date
10/15/2014
Last updated
10/15/2014
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