1609326727 NPI number — TCM QUALITY SERVICES,INC

Table of content: (NPI 1609326727)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1609326727 NPI number — TCM QUALITY SERVICES,INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
TCM QUALITY 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:
1609326727
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/02/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2804 DEL PRADO BLVD S
Provider Second Line Business Mailing Address:
#209 SUITE-3
Provider Business Mailing Address City Name:
CAPE CORAL
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33904-7252
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
813-900-3356
Provider Business Mailing Address Fax Number:
305-503-7143

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2804 DEL PRADO BLVD S
Provider Second Line Business Practice Location Address:
#209 SUITE-3
Provider Business Practice Location Address City Name:
CAPE CORAL
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33904-7252
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
813-900-3356
Provider Business Practice Location Address Fax Number:
305-503-7143
Provider Enumeration Date:
10/12/2016

Additional Information

Authorized Official

Authorized Official Last Name:
MARTINEZ
Authorized Official First Name:
EDUARDO
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
813-900-3356

Provider Taxonomy Codes

  • Taxonomy code: 251B00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 018939200 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com