1215995287 NPI number — QUALITY HOME HEALTH CARE, INC.

Table of content: (NPI 1215995287)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1215995287 NPI number — QUALITY HOME HEALTH CARE, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
QUALITY HOME HEALTH CARE, 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:
1215995287
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/30/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 10
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PARSONS
Provider Business Mailing Address State Name:
TN
Provider Business Mailing Address Postal Code:
38363-0010
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
731-847-1356
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
279 W MAIN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CAMDEN
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
38320
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
731-584-2700
Provider Business Practice Location Address Fax Number:
731-584-3866
Provider Enumeration Date:
05/01/2006

Additional Information

Authorized Official

Authorized Official Last Name:
BRADLEY
Authorized Official First Name:
ROBIN
Authorized Official Middle Name:
F
Authorized Official Title or Position:
SECRETARY
Authorized Official Telephone Number:
615-595-8383

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X , with the licence number:  0000000008 , registered in the state of TN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 3404243 . This is a "CAHABA MEDICARE PART B" identifier , issued by the state of ( TN ) . This identifiers is of the category "OTHER".
  • Identifier: 6012 , issued by the state of ( TN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 91151 . This is a "STERLING LIFE INS.-OPT 1" identifier , issued by the state of ( TN ) . This identifiers is of the category "OTHER".
  • Identifier: 4041175 . This is a "BCBS" identifier , issued by the state of ( TN ) . This identifiers is of the category "OTHER".
  • Identifier: 155880 , issued by the state of ( TN ) . This identifiers is of the category "MEDICAID".




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