1205904935 NPI number — QUEST SERVICES, INC.

Table of content: (NPI 1205904935)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1205904935 NPI number — QUEST SERVICES, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
QUEST 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:
Provider Other Organization Name Type Code:
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:
1205904935
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/07/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
236 GAME RESERVE RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PHILIPSBURG
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
16866-9337
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
814-342-6740
Provider Business Mailing Address Fax Number:
814-342-6740

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
15 & PINE STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PHILIPSBURG
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
16866
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
814-342-2231
Provider Business Practice Location Address Fax Number:
814-342-1515
Provider Enumeration Date:
12/01/2006

Additional Information

Authorized Official

Authorized Official Last Name:
LAZAR
Authorized Official First Name:
LEE ANN
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
814-342-6740

Provider Taxonomy Codes

  • Taxonomy code: 251S00000X , with the licence number:  147025 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 001751620 0002 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com