1114175387 NPI number — TOTAL QUALITY RESIDENTIAL SERVICES, INC.

Table of content: (NPI 1114175387)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1114175387 NPI number — TOTAL QUALITY RESIDENTIAL SERVICES, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
TOTAL QUALITY RESIDENTIAL SERVICES, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
TOTAL QUALITY RESIDENTIAL SERVICES, INC.
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1114175387
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/09/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4121 SIHLER OAKS TRL
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
OWINGS MILLS
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21117-5004
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
410-802-3815
Provider Business Mailing Address Fax Number:
443-703-2331

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
225 S WHITING ST APT 124
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ALEXANDRIA
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
22304-7117
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
410-802-3815
Provider Business Practice Location Address Fax Number:
443-703-2331
Provider Enumeration Date:
08/30/2008

Additional Information

Authorized Official

Authorized Official Last Name:
PURNELL
Authorized Official First Name:
DARREN
Authorized Official Middle Name:
LAMONT
Authorized Official Title or Position:
CHIEF ADMINISTRATIVE OFFICER
Authorized Official Telephone Number:
410-802-3815

Provider Taxonomy Codes

  • Taxonomy code: 251C00000X , with the licence number:  1223-14-001 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 322D00000X , with the licence number: 1223-14-001 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 323P00000X , with the licence number: 1223-14-001 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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