1548373574 NPI number — QUALITY COMMUNITY HEALTH CARE, INC.

Table of content: (NPI 1548373574)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1548373574 NPI number — QUALITY COMMUNITY HEALTH CARE, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
QUALITY COMMUNITY 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:
1548373574
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/27/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2501 W LEHIGH AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PHILADELPHIA
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
19132-3207
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
215-227-0300
Provider Business Mailing Address Fax Number:
215-227-0302

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2300 W MASTER ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PHILADELPHIA
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19121-4739
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
215-236-8289
Provider Business Practice Location Address Fax Number:
215-236-3521
Provider Enumeration Date:
08/16/2006

Additional Information

Authorized Official

Authorized Official Last Name:
LINGHAM
Authorized Official First Name:
MARCELLA
Authorized Official Middle Name:
E.
Authorized Official Title or Position:
EXECUTIVE DIRECTOR
Authorized Official Telephone Number:
215-227-0300

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 1007588070004 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".




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