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NPI Code Detail

MEDICARE: QUEEN CITY ENTERPRISES

MEDICARE: QUEEN CITY ENTERPRISES
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1133N00000XNutritionist
2253Z00000XIn Home Supportive Care Agency
3332U00000XHome Delivered Meals
4171400000XHealth & Wellness Coach
5174200000XMeals Provider
6251E00000XHome Health Agency
7251K00000XPublic Health or Welfare Agency
8133NN1002XNutrition Education Nutritionist

General Provider Information

NPI Number : 1679386809
Entity Type Code : Organization
Provider Name (Legal Business Name) : QUEEN CITY ENTERPRISES
Provider Business Mailing Address
First Line : 6163 VERMILION LOOP
Second Line :
City : GRANITEVILLE
State : SC
Zip : 29829-3261
Country : US
Telephone Number : 951-553-3051
Fax Number :
Provider Business Practice Location Address
First Line : 823 BROAD ST
Second Line :
City : AUGUSTA
State : GA
Zip : 30901-1214
Country : US
Telephone Number : 951-553-3051
Fax Number :
Authorized Official
Title or Position : HOLISTIC NUTRITIONIST COUNSELOR
Name : ASET AUGUST
Credential : CERTIFIED
Telephone Number : 951-553-3051
Provider Enumeration Date : 01/30/2025
Last Update Date : 01/30/2025

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Directions to “QUEEN CITY ENTERPRISES ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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