MEDICARE: QAZ HOME CARE SERVICES

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

General Provider Information

NPI Number	:	1386150829
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	QAZ HOME CARE SERVICES

Provider Business Mailing Address
First Line	:	71 LEGION PKWY STE 16
Second Line	:
City	:	BROCKTON
State	:	MA
Zip	:	02301-7225
Country	:	US
Telephone Number	:	508-219-0201
Fax Number	:	508-977-7535

Provider Business Practice Location Address
First Line	:	71 LEGION PKWY STE 16
Second Line	:
City	:	BROCKTON
State	:	MA
Zip	:	02301-7225
Country	:	US
Telephone Number	:	508-219-0201
Fax Number	:	508-977-7535

Authorized Official
Title or Position	:	OWNER
Name	:	MR. PELEGE MARCELLIN
Credential	:
Telephone Number	:	774-259-7787

Provider Enumeration Date	:	12/20/2017
Last Update Date	:	10/15/2020

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