Healthcare Provider Details

I. General information

NPI: 1285071969
Provider Name (Legal Business Name): TIM'S HOME MEDICAL OF ST MARY'S, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/04/2013
Last Update Date: 10/13/2023
Certification Date: 10/13/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

685 KINGSBAY RD
SAINT MARYS GA
31558-3889
US

IV. Provider business mailing address

685 KINGSBAY RD
SAINT MARYS GA
31558-3889
US

V. Phone/Fax

Practice location:
  • Phone: 912-882-7227
  • Fax: 912-882-8827
Mailing address:
  • Phone: 912-882-7227
  • Fax: 912-882-8827

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: TIMOTHY LEE SLOAN
Title or Position: OWNER
Credential:
Phone: 912-294-1284