Provider Demographics
NPI:1821367020
Name:MORRIS, MARGO MOSTELLER (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:MARGO
Middle Name:MOSTELLER
Last Name:MORRIS
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2414 SYLVESTER RD
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:GA
Mailing Address - Zip Code:31705-2469
Mailing Address - Country:US
Mailing Address - Phone:229-430-9119
Mailing Address - Fax:229-430-9114
Practice Address - Street 1:2414 SYLVESTER RD
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:GA
Practice Address - Zip Code:31705-2469
Practice Address - Country:US
Practice Address - Phone:229-430-9119
Practice Address - Fax:229-430-9114
Is Sole Proprietor?:No
Enumeration Date:2011-12-19
Last Update Date:2011-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH023748183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist