Organization
HOME MEDICAL PROFESSIONAL SERVICE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ETHAN DARNELLE BROWN SR. (OWNER)
(478) 471-7715
Entity
Organization
Contact information
Practice address
4480 RIVERSIDE DRIVE, SUITE 11, MACON, GA 31210
(478) 471-7715
(478) 757-0234
Mailing address
PO BOX 7967, MACON, GA 31209
(478) 471-7715
(478) 757-0234
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
10/11/2006
Last updated
08/22/2020
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