1144234071 NPI number — QUANTUM HEALTHCARE, INC.

Table of content: (NPI 1144234071)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1144234071 NPI number — QUANTUM HEALTHCARE, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
QUANTUM HEALTHCARE, 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:
Provider Other Organization Name Type Code:
6
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:
1144234071
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/20/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
983 EXCHANGE ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
VERMILION
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
44089-1256
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
440-967-6614
Provider Business Mailing Address Fax Number:
440-967-1968

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
983 EXCHANGE ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
VERMILION
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
44089-1256
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
440-967-6614
Provider Business Practice Location Address Fax Number:
440-967-1968
Provider Enumeration Date:
07/28/2006

Additional Information

Authorized Official

Authorized Official Last Name:
RANKIN
Authorized Official First Name:
STEVEN
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT/ADMINISTRATOR
Authorized Official Telephone Number:
440-967-6617

Provider Taxonomy Codes

  • Taxonomy code: 314000000X , with the licence number:  1902N , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 000000385006 . This is a "ANTHEM OCCUPATIONAL THERA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 000000374807 . This is a "ANTHEM SKILLED NURSING" identifier . This identifiers is of the category "OTHER".
  • Identifier: 000000385007 . This is a "ANTHEM SPEECH THERAPY" identifier . This identifiers is of the category "OTHER".
  • Identifier: 2510652 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 7551125 . This is a "AETNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 000000385004 . This is a "ANTHEM PHYSICAL THERAPY" identifier . This identifiers is of the category "OTHER".




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