1740364538 NPI number — QUALITY MEDICAL CARE AND SERVICES, LLC

Table of content: MS. RYNN MARIE GEIER RD, LD, CDE (NPI 1073682779)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1740364538 NPI number — QUALITY MEDICAL CARE AND SERVICES, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
QUALITY MEDICAL CARE AND SERVICES, LLC
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:
1740364538
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/05/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
903 TATE COVE RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
VILLE PLATTE
Provider Business Mailing Address State Name:
LA
Provider Business Mailing Address Postal Code:
70586-3600
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
337-363-8101
Provider Business Mailing Address Fax Number:
337-363-8656

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
107 HOSPITAL DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
OAKDALE
Provider Business Practice Location Address State Name:
LA
Provider Business Practice Location Address Postal Code:
71463-3034
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
318-335-3370
Provider Business Practice Location Address Fax Number:
318-335-0593
Provider Enumeration Date:
10/25/2006

Additional Information

Authorized Official

Authorized Official Last Name:
ASWELL
Authorized Official First Name:
CHARLES
Authorized Official Middle Name:
J.
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
337-363-7474

Provider Taxonomy Codes

  • Taxonomy code: 332B00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 1459984 , issued by the state of ( IN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 4500442 . This is a "MEDICAID SUBMITTER ID NUMBER" identifier , issued by the state of ( LA ) . This identifiers is of the category "OTHER".
  • Identifier: C08406281 . This is a "MEDICARE SUBMITTER ID NUMBER" identifier , issued by the state of ( LA ) . This identifiers is of the category "OTHER".




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