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General NPI Number Information
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NPI Number | 1477039378
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Entity Type | Organization
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Legal Business Name | QUAD E CORP
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Dates
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Enumeration Date | 07/13/2018
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Last Update Date | 07/13/2018
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Provider Practice Location Address
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Address Line | 301 OLIVE ST
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City | HINESVILLE
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State | GA
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Zip | 31313-2915
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Country | US
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Telephone | 912-436-3488
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Fax | 912-436-3487
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Provider Business Mailing Address
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Address Line | 2 CORPUS CHRISTIE PL STE 200
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City | HILTON HEAD
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State | SC
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Zip | 29928-1712
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Country | US
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Telephone | 912-436-3488
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Fax | 912-436-3487
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | MRS. MARY ANN STREETER
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Credential | NURSE PRACTITIONER
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Telephone | 803-447-9460
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251300000X
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Taxonomy Name | Local Education Agency (LEA)
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QC1500X
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Taxonomy Name | Community Health Clinic/Center
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License Number |
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License Number State |
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