Healthcare Provider Details

I. General information

NPI: 1477501021
Provider Name (Legal Business Name): JHM,INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/05/2006
Last Update Date: 03/30/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

159 E BROAD ST
CAMILLA GA
31730-1842
US

IV. Provider business mailing address

PO BOX 394
CAMILLA GA
31730-0394
US

V. Phone/Fax

Practice location:
  • Phone: 229-336-7654
  • Fax: 229-336-5615
Mailing address:
  • Phone: 229-336-7654
  • Fax: 229-336-5615

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3336C0002X
TaxonomyClinic Pharmacy
License NumberPHRE004923
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License NumberPHRE004923
License Number StateGA
# 3
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberPHRE004923
License Number StateGA

VIII. Authorized Official

Name: DR. JOE HARRIS MORGAN
Title or Position: CEO/PHARMACIST
Credential: PHARM D
Phone: 229-336-7654