1487657854 NPI number — QUALITY HOME HEALTH CARE, INC.

Table of content: (NPI 1487657854)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1487657854 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:
1487657854
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/13/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1515 S SAM RAYBURN FWY
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SHERMAN
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75090-8735
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
903-892-9281
Provider Business Mailing Address Fax Number:
903-870-0580

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1515 S SAM RAYBURN FWY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SHERMAN
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
75090-8735
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
903-892-9281
Provider Business Practice Location Address Fax Number:
903-870-0580
Provider Enumeration Date:
05/31/2005

Additional Information

Authorized Official

Authorized Official Last Name:
VANSICKLE
Authorized Official First Name:
DUSTIN
Authorized Official Middle Name:
EUGENE
Authorized Official Title or Position:
CEO/CFO/OWNER
Authorized Official Telephone Number:
903-892-9281

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X , with the licence number:  016727 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 3747P1801X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 016727 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 945419162 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1962405431 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 945411162 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 001015454 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 000632900 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 945221160 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 945539168 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 001026953 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 677638 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 008002 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 024770201 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 945418162 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 945542160 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".




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