Healthcare Provider Details

I. General information

NPI: 1598541476
Provider Name (Legal Business Name): QIMAA HOME HEALTHCARE SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/06/2023
Last Update Date: 09/06/2023
Certification Date: 09/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5 MESSINA DR
SWEDESBORO NJ
08085-3081
US

IV. Provider business mailing address

5 MESSINA DR
SWEDESBORO NJ
08085-3081
US

V. Phone/Fax

Practice location:
  • Phone: 856-371-6007
  • Fax:
Mailing address:
  • Phone: 856-371-6007
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: AUGUSTA E MOMODU
Title or Position: EXECUTIVE DIRECTOR /ADMINISTRATOR
Credential: PHARM D.
Phone: 856-371-6007