MEDICARE: QNC HOME CARE SERVICES LLC

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	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1184364531
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	QNC HOME CARE SERVICES LLC

Provider Business Mailing Address
First Line	:	110 DYSART PL APT J
Second Line	:
City	:	FAYETTEVILLE
State	:	NC
Zip	:	28314-4300
Country	:	US
Telephone Number	:	910-835-5464
Fax Number	:

Provider Business Practice Location Address
First Line	:	429 PERSON ST STE 6
Second Line	:
City	:	FAYETTEVILLE
State	:	NC
Zip	:	28301-5737
Country	:	US
Telephone Number	:	910-835-5464
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	CHRYSANDRA ROGERS
Credential	:
Telephone Number	:	910-929-4687

Provider Enumeration Date	:	03/31/2022
Last Update Date	:	04/01/2022

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