MEDICARE: QUALITY HEALTH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency	160000792	TN

General Provider Information

NPI Number	:	1023477171
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	QUALITY HEALTH

Provider Business Mailing Address
First Line	:	2860 MORNING LAKE DR APT 201
Second Line	:
City	:	CORDOVA
State	:	TN
Zip	:	38016-2408
Country	:	US
Telephone Number	:	901-273-3142
Fax Number	:

Provider Business Practice Location Address
First Line	:	2860 MORNING LAKE DR APT 201
Second Line	:
City	:	CORDOVA
State	:	TN
Zip	:	38016-2408
Country	:	US
Telephone Number	:	901-273-3142
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MRS. TAMBA LASHEA JAKCOSN
Credential	:	BSHA
Telephone Number	:	901-273-3142

Provider Enumeration Date	:	02/17/2016
Last Update Date	:	02/17/2016

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