Organization
GEORGIA INFUSION SERVICES, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. STEPHEN E CUMMINGS RN (PRESIDENT)
(912) 489-1179
Entity
Organization
Contact information
Practice address
510 GENTILLY RD, STATESBORO, GA 30458-5149
(912) 489-1179
(912) 489-8927
Mailing address
PO BOX 287, STATESBORO, GA 30459-0287
(912) 489-1179
(912) 489-8927
Taxonomy
Speciality
Code
Description
License number
State
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
Primary
PHRE008237
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00672658A
—
GA
05
—
00672658B
—
GA
Enumeration date
07/15/2005
Last updated
08/06/2007
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