Organization
QUEEN CITY HOME MEDICAL, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAMELIA GALE WHITE (OWNER)
(229) 723-8009
Entity
Organization
Contact information
Practice address
11510 COLUMBIA ST, SUITE J, BLAKELY, GA 39823-2788
(229) 723-8009
(229) 723-8005
Mailing address
11510 COLUMBIA ST, SUITE J, BLAKELY, GA 39823-2788
(229) 723-8009
(229) 723-8005
Taxonomy
Speciality
Code
Description
License number
State
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
20015314787
GA
Other
Enumeration date
06/21/2006
Last updated
04/14/2017
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