Provider Demographics
NPI:1568410108
Name:MORGAN MEDICAL, INC.
Entity Type:Organization
Organization Name:MORGAN MEDICAL, INC.
Other - Org Name:OPTIONCARE OF CAMILLA
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:CEO/PHARMACIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:MORGAN
Authorized Official - Last Name:MILLSAPS
Authorized Official - Suffix:
Authorized Official - Credentials:PHARM D
Authorized Official - Phone:229-336-7758
Mailing Address - Street 1:PO BOX 394
Mailing Address - Street 2:
Mailing Address - City:CAMILLA
Mailing Address - State:GA
Mailing Address - Zip Code:31730-0394
Mailing Address - Country:US
Mailing Address - Phone:229-336-7758
Mailing Address - Fax:229-336-5615
Practice Address - Street 1:159 E BROAD ST
Practice Address - Street 2:
Practice Address - City:CAMILLA
Practice Address - State:GA
Practice Address - Zip Code:31730-1842
Practice Address - Country:US
Practice Address - Phone:229-336-7758
Practice Address - Fax:229-336-5615
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-05
Last Update Date:2008-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPHRE007852251E00000X, 251F00000X, 251J00000X, 332B00000X, 332BN1400X, 332BP3500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251F00000XAgenciesHome Infusion
No251E00000XAgenciesHome Health
No251J00000XAgenciesNursing Care
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BN1400XSuppliersDurable Medical Equipment & Medical SuppliesNursing Facility Supplies
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000683218BMedicaid
GA1146364OtherNABP-OPTIONCARE
GA1146364OtherNABP-OPTIONCARE