Healthcare Provider Details

I. General information

NPI: 1174260830
Provider Name (Legal Business Name): EQW SOLUTIONS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/16/2022
Last Update Date: 05/16/2022
Certification Date: 05/16/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

612 KESWICK VILLAGE CT NE
CONYERS GA
30013-6523
US

IV. Provider business mailing address

612 KESWICK VILLAGE CT NE
CONYERS GA
30013-6523
US

V. Phone/Fax

Practice location:
  • Phone: 678-800-5091
  • Fax:
Mailing address:
  • Phone: 678-800-5091
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: QUATINA WILLIS
Title or Position: OWNER
Credential: LPN
Phone: 678-800-5091