Provider Demographics
NPI:1699437640
Name:QUALITICARE COMMUNITY MEDICAL SERVICES LLC
Entity type:Organization
Organization Name:QUALITICARE COMMUNITY MEDICAL SERVICES LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JAVED
Authorized Official - Middle Name:COUNSELING SERVICE O
Authorized Official - Last Name:AKHTAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:302-469-5333
Mailing Address - Street 1:7586 S DUPONT HWY STE 4
Mailing Address - Street 2:
Mailing Address - City:FELTON
Mailing Address - State:DE
Mailing Address - Zip Code:19943-5786
Mailing Address - Country:US
Mailing Address - Phone:302-469-5333
Mailing Address - Fax:
Practice Address - Street 1:7586 S DUPONT HWY STE 4
Practice Address - Street 2:
Practice Address - City:FELTON
Practice Address - State:DE
Practice Address - Zip Code:19943-5786
Practice Address - Country:US
Practice Address - Phone:302-469-5333
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-07
Last Update Date:2024-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty