Healthcare Provider Details

I. General information

NPI: 1801809025
Provider Name (Legal Business Name): QUALCARE SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/15/2006
Last Update Date: 08/22/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

958 CHURCH ST 2ND FLOOR
BALDWIN NY
11510-4257
US

IV. Provider business mailing address

958 CHURCH ST 2ND FLOOR
BALDWIN NY
11510-4257
US

V. Phone/Fax

Practice location:
  • Phone: 516-809-0135
  • Fax:
Mailing address:
  • Phone: 516-809-0135
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: SANJAY AHUJA
Title or Position: OWNER
Credential:
Phone: 917-514-2881