Healthcare Provider Details

I. General information

NPI: 1467396903
Provider Name (Legal Business Name): QSWP GROUP LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/15/2026
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1505 HARMON DR
VALDOSTA GA
31601-3571
US

IV. Provider business mailing address

1505 HARMON DR
VALDOSTA GA
31601-3571
US

V. Phone/Fax

Practice location:
  • Phone: 229-541-6286
  • Fax:
Mailing address:
  • Phone: 229-541-6286
  • Fax:

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: STEPHANIE PAUL
Title or Position: OWNER/CEO
Credential:
Phone: 229-541-6286