Healthcare Provider Details

I. General information

NPI: 1033307426
Provider Name (Legal Business Name): TOTAL QUALITY HEALTH SYSTEMS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/10/2007
Last Update Date: 09/12/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2302 WEST MEADOWVIEW RD SUITE 222
GREENSBORO NC
27407-3750
US

IV. Provider business mailing address

PO BOX 5790
GREENSBORO NC
27435-0790
US

V. Phone/Fax

Practice location:
  • Phone: 336-617-6051
  • Fax: 336-617-6053
Mailing address:
  • Phone: 336-617-6051
  • Fax: 336-617-6053

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License NumberHC1601
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License NumberHC1601
License Number StateNC

VIII. Authorized Official

Name: MR. JEROME R. FOX II
Title or Position: CEO/OWNER
Credential:
Phone: 336-294-7656