Organization
REGION XI FIELD FISCAL OFFICE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GINA MORRIS (ACCOUNTANT)
(912) 389-4691
Entity
Organization
Contact information
Practice address
1400 PETERSON AVE N STE D, DOUGLAS, GA 31533-2833
(912) 389-4691
Mailing address
PO BOX 690, DOUGLAS, GA 31534-0690
(912) 389-4691
(912) 389-4996
Taxonomy
Speciality
Code
Description
License number
State
251K00000X
Public Health or Welfare Agency
Primary
—
—
Other
Enumeration date
05/15/2019
Last updated
05/15/2019
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