Organization
QBC HOME MEDICAL SUPPLY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHANCI SHERMAINE SHAW MHA (PROGRAM DIRECTOR)
(337) 623-2353
Entity
Organization
Contact information
Practice address
509 CHURCH STREET, MELVILLE, LA 71353
(337) 623-2353
(337) 623-2369
Mailing address
PO BOX 617, MELVILLE, LA 71353-0617
(337) 623-2353
(337) 623-2369
Taxonomy
Speciality
Code
Description
License number
State
251G00000X
Community Based Hospice Care Agency
Primary
1778583
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1778583
—
LA
Enumeration date
05/31/2007
Last updated
10/18/2007
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