Organization
QUAD E CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MARY ANN STREETER NURSE PRACTITIONER (PRESIDENT/CEO)
(803) 447-9460
Entity
Organization
Contact information
Practice address
301 OLIVE ST, HINESVILLE, GA 31313-2915
(912) 436-3488
(912) 436-3487
Mailing address
2 CORPUS CHRISTIE PL STE 200, HILTON HEAD, SC 29928-1712
(912) 436-3488
(912) 436-3487
Taxonomy
Speciality
Code
Description
License number
State
251300000X
Local Education Agency (LEA)
—
—
251S00000X
Community/Behavioral Health Agency
—
—
261QC1500X
Community Health Clinic/Center
Primary
—
—
Other
Enumeration date
07/13/2018
Last updated
07/13/2018
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