Provider Demographics
NPI:1528475563
Name:QUALITY HEALTH CARE SERVICES, PA
Entity type:Organization
Organization Name:QUALITY HEALTH CARE SERVICES, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GERALDINE
Authorized Official - Middle Name:Q
Authorized Official - Last Name:YOUNG
Authorized Official - Suffix:
Authorized Official - Credentials:DNP, FNP-BC
Authorized Official - Phone:769-572-5280
Mailing Address - Street 1:PO BOX 83081
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MS
Mailing Address - Zip Code:39283-3081
Mailing Address - Country:US
Mailing Address - Phone:769-572-5280
Mailing Address - Fax:769-572-5250
Practice Address - Street 1:4510 HANGING MOSS RD
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MS
Practice Address - Zip Code:39206-3962
Practice Address - Country:US
Practice Address - Phone:769-572-5280
Practice Address - Fax:769-572-5250
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-22
Last Update Date:2014-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSR861956261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care