Provider Demographics
NPI:1194890533
Name:QUALCARE THERAPY CENTER
Entity type:Organization
Organization Name:QUALCARE THERAPY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT AND CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:
Authorized Official - Last Name:MENDONEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-979-6161
Mailing Address - Street 1:2333 MORRIS AVE
Mailing Address - Street 2:SUITE C-3
Mailing Address - City:UNION
Mailing Address - State:NJ
Mailing Address - Zip Code:07083-5714
Mailing Address - Country:US
Mailing Address - Phone:908-688-3366
Mailing Address - Fax:908-688-8115
Practice Address - Street 1:2333 MORRIS AVE
Practice Address - Street 2:SUITE C-3
Practice Address - City:UNION
Practice Address - State:NJ
Practice Address - Zip Code:07083-5714
Practice Address - Country:US
Practice Address - Phone:908-688-3366
Practice Address - Fax:908-688-8115
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ5130700001Medicare ID - Type Unspecified