MEDICARE: MIDDLE FLINT AREA COMMUNITY SERVICE BOARD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1679135453
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MIDDLE FLINT AREA COMMUNITY SERVICE BOARD

Provider Business Mailing Address
First Line	:	PO BOX 1348
Second Line	:
City	:	AMERICUS
State	:	GA
Zip	:	31709-1348
Country	:	US
Telephone Number	:	229-815-5454
Fax Number	:	229-815-6606

Provider Business Practice Location Address
First Line	:	512 MILLARD FULLER BLVD
Second Line	:
City	:	AMERICUS
State	:	GA
Zip	:	31709-3425
Country	:	US
Telephone Number	:	229-815-1169
Fax Number	:	229-816-6606

Authorized Official
Title or Position	:	RCM MANAGER
Name	:	MARGARET JORDAN
Credential	:
Telephone Number	:	229-815-5454

Provider Enumeration Date	:	07/02/2019
Last Update Date	:	01/29/2024

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