| Queen Of Safety Supply Co., Llc | |
|
9500 County Road 190 Manvel TX 77578-5078 | |
| (225) 788-7048 | |
| Not Available |
| Full Name | Queen Of Safety Supply Co., Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 9500 County Road 190, Manvel, Texas |
| Authorized Official Name and Position | Rachael Shannel Costly (CEO) |
| Authorized Official Contact | 2257887048 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Queen Of Safety Supply Co., Llc Po Box 720034 Houston TX 77272-0034 Ph: (225) 788-7048 | Queen Of Safety Supply Co., Llc 9500 County Road 190 Manvel TX 77578-5078 Ph: (225) 788-7048 |
| NPI Number | 1578182838 |
|---|---|
| Provider Enumeration Date | 04/15/2020 |
| Last Update Date | 04/15/2020 |
| Certification Date | 04/15/2020 |
| Medicare PECOS PAC ID | 3476947979 |
|---|---|
| Medicare Enrollment ID | O20220228000049 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578182838 | NPI | - | NPPES |
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