Healthcare Provider Details

I. General information

NPI: 1811268386
Provider Name (Legal Business Name): EXCEPTIONAL MEDICAL SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/16/2012
Last Update Date: 01/16/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20 HALYARD DR
PORT WENTWORTH GA
31407-9755
US

IV. Provider business mailing address

20 HALYARD DR
PORT WENTWORTH GA
31407-9755
US

V. Phone/Fax

Practice location:
  • Phone: 912-272-5229
  • Fax:
Mailing address:
  • Phone: 912-272-5229
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: DAVEEDA MARIE ARGROW
Title or Position: OWNER AND MEMBER
Credential:
Phone: 912-272-5229